卵巢性索间质肿瘤的CT诊断

摘要

目的 探讨卵巢性索间质肿瘤的CT表现特点,提高术前诊断准确率.方法回顾性分析经手术病理证实的21例卵巢性索间质肿瘤的临床和CT资料.结果 ①纤维卵泡膜细胞瘤9例10个肿瘤,实性7个,囊性2个,囊实性多房改变1个.实性肿瘤和囊实性肿瘤的实性部分及其囊壁平扫呈等或稍低密度,增强后无强化或有轻度强化,囊性或囊实性肿瘤的囊、实部分界限清晰,可见壁结节.②卵泡膜细胞瘤6例,平扫呈均匀或不均匀低密度实性肿块,增强扫描中实性部分均表现为轻微强化.③颗粒细胞瘤5例,多房囊性3例,囊实性1例,实性1例.实性肿瘤实质明显不均质强化;而多房囊性和囊实性肿瘤内实质轻至中度强化.④硬化性间质瘤1例,平扫时密度不均呈囊实性,增强后肿块边缘部分早期强化,延迟扫描呈显著强化.结论 卵巢性索间质肿瘤的CT在肿瘤的形态、密度及强化方式等方面具有一定特点,结合患者的临床表现有助于提高诊断准确率.%Objective To describe the CT characteristics and improve prc-opcrativc diagnosis of sex cord-stromal tumor of the ovary. Methods The clinical and CT findings in 21 patients with sex cord-stromal tumor of the ovary proved by surgery and pathology were retrospectively analyzed. Results ① Of 21 sex cord-stromal tumors of the ovary, 9 cases with 10 tumors were fibrotheco-ma. There were solid tumors(n-7), cystic tumors (n - 2 )and cystic-solid tumor(n-1 ). On CT images, the solid tumor, the solid part of the cystic-solid tumor and the cystic wall were isodensity or slight hypodensity on prccontrast scans, and there was no or slight uptake on postcontrast enhancement. In cystic or cystic-solid tumors, the demarcation between the cystic and solid portion was clear. Nodules on cystic wall were visible. ② 6 thecomas showed a unilateral isodense solid masses with homogeneous or heterogeneous density on prccontrast images. After contrast administration, all lesions showed no or slight enhancement. ③ There were 5 granulosc cell tumors, including multilocular cystic tumors(n -3) , cystic-solid tumor and solid tuomr (n- 1 ). The solid tumors were obvious heterogeneous enhancement, but the solid parts of the cystic-solid tumor and the multilocular cystic tumors were slight or moderate enhancement after contrast administration. ④One case of sclcrosing stromal tumor was cystic-solid with heterogeneous density on prccontrast images, the tumors marked marginal enhancement was showed in the early phase, and consistent significant enhancement in the delayed phase of contrast CT. Conclusion CT findings of sex cord-stromal tumors of the ovary arc of some characteristics in the sharp, density, and the manner of enhancement, CT appearances in combination with clinical features can improve the accurate rate in diagnosis of this tumor.