目的 探讨卵巢透明细胞癌(OCCC)的MRI表现.方法 回顾性分析19例经手术病理证实的OCCC患者的临床、MRI及病理资料,总结其MRI表现.结果 19例均为单侧卵巢肿块.13例患者合并盆腔子宫内膜异位症.肿瘤的MRI表现:(1)肿瘤的形态学表现:肿瘤长径平均约11.8cm.病灶呈类圆形、类椭圆形或不规则形.边界清楚.囊性病灶11例、囊实性病灶3例,实性病灶5例.囊性病灶中,10例为单房囊性病灶伴有壁结节,1例为多房囊性病灶且无壁结节.3例实性病灶均见坏死、囊变.(2)肿瘤的信号特点:17例患者可见病灶内T1高信号;囊性部分信号在T1WI复杂多变,T2WI均呈高信号;实性部分T1WI呈等信号或稍低信号,T2WI呈稍高信号,DWI呈弥散受限改变.(3)增强扫描特征:囊壁、分隔及病灶内实性部分动脉期呈中度强化,静脉期及平衡期呈持续中度或明显强化状态,内部强化不均.结论 OCCC的MRI表现有一定特征性,以伴有壁结节的单房囊性病灶多见,病灶内T1WI高信号及合并子宫内膜异位症有助于诊断.%Objective To explore the MRI manifestation of ovarian clear cell carcinoma. Methods The clinical,pathologic data and MRI findings in 19 patients with ovarian clear cell carcinoma confirmed by operation and pathologic examination were retrospectively analyzed. Results Unilateral mass was revealed in 19 patients. 13 cases coexisted with endometriosis. The MRI features of ovarian clear cell carcinoma were as follows:(1)Morphologic features:The mean maximum diameter was 11.8cm. The masses showed nearly-round,nearly-oval or irregular in shape with clear boundary. Cystic mass was found in 11 cases,cyst-solidary mass was found in 3 cases,solid mass was found in 5 cases. A unilocular or large cystic mass with solid protrusions was found in 10 cases,and a multilocular cystic mass with no protrusions was found in 1 case.(2)Signal characteristics:T1-hyperintensity was observed in 17 masses. The cystic component showed heterogenous signal intensity on T1WI,and high signal intensity on T2WI. The solid component showed isointensity or slightly low signal intensity on T1WI,slightly high signal intensity on T2WI,and high signal intensity on DWI.(3)Characteristics of enhancement:The wall,septa and solid component were moderately enhanced in arterial phase and obviously enhanced in venous and equilibrium phase. Conclusion The MRI manifestation of ovarian clear cell carcinoma is certainly specific,the common imaging findings including a unilocular or large cyst with solid protrusions. The findings of T1-hyperintensity and endometriosis help to diagnose.
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