卵巢无性细胞瘤的影像学表现

摘要

目的:总结分析卵巢无性细胞瘤的影像学表现.方法:回顾性分析经病理证实的8例卵巢无性细胞瘤的临床及影像表现.结果:8例均为单发,病灶位于右侧卵巢6例,左侧2例,单纯型7例,混合型1例,5例伴有血清乳酸脱氢酶(LDH)或β-人绒毛膜促性腺激素(β-HCG)升高.单纯型卵巢无性细胞瘤表现为以实性成分为主的类圆形或分叶状软组织肿块,T1WI呈等或稍低信号,T2 WI呈等或稍高信号,T2抑脂序列呈混杂高信号,增强扫描实性部分轻中度强化,病灶周围及中央可见环形强化的包膜及纤维血管分隔,部分包绕同侧髂血管；混合型无性细胞瘤表现为囊实性肿块,囊变坏死多见,边界不规整.结论:单纯型卵巢无性细胞瘤影像表现有一定的特征性,结合血清LDH或β-HCG的升高,多数可确诊；混合型卵巢无性细胞瘤影像表现缺乏特异性,容易误诊.%Objective:To explore imaging appearance and differential diagnosis of ovarian dysgerminoma.Methods:CT and MRI manifestations of eight cases with ovarian dysgerminoma confirmed by pathology were analyzed retrospectively.Results:8 cases exhibited solitary lesions,of which 6 cases were located in the right ovary,2 cases in the left ovary.7 cases showed simple type and 1 case showed mixed type,5 cases being accompaned with serum lactate dehydrogenase (LDH) or β-human chorionic gonadotropin (β-HCG) elevation.Simple ovarian dysgerminoma manifested itself as a round or lobulated soft tissue mass mainly consisting of solid components,with iso-/slightly hypo-intensity on T1 WI,iso-/slightly hyper-intensity on T2 WI and mixed hyper-intensity on fat-suppressed (FS) T2 WI.The solid portion enhanced slightly to moderately,and enhanced capsule and fibrovascular speta could be seen in the peripheral and central areas,part of which surrounded the ipsilateral iliac vessel.Mixed ovarian dysgerminoma presented as cystic and solid masses,with cystic necrosis and irregular boundary.Conclusion:Simple ovarian dysgerminoma has certain characteristics image appearance,combinined wih the increase of serum lactate dehydrogenase or β-human chorionic gonadotropin,most cases can be correctely diagnosed; while mixed ovaian dysgerminoma can easily be misdiagnosed because its images are lacking of specificity.