| 摘要: |
| 目的探讨卵巢硬化性间质瘤的CT、MRI表现及其病理组织特征，以期提高对本病的认识。方法回顾性分析30例经手术病理证实的卵巢硬化性间质瘤临床资料、CT（22例）和MR（8例）图像及病理资料，分析卵巢硬化性间质瘤的CT和MR表现及病理学特征。结果30例卵巢硬化性间质瘤均为单发，右侧18例，左侧12例。肿瘤长径1.5~12.3cm。肿瘤呈均匀实性12例（12/30），呈囊实混杂性18例（18/30），囊实性肿块在T2WI上表现为“湖岛征”。CT和MR增强扫描肿瘤实质呈现3种类型强化方式：（1）早期周边显著强化，后期向心性渐进，类似“肝脏海绵状血管瘤”强化方式（16例）；（2）早期明显均匀强化，后期持续强化（10例）；（3）早期轻度强化，后期持续强化，但强化程度不如（1）和（2）类型（4例）。病理检查30例均可见假小叶结构、印戒细胞、致密胶原纤维、疏松水肿结缔组织及丰富血管。免疫组化Vimentin、SMA及PR均（+）；CK、EMA和S-100均（-）。结论卵巢硬化性间质瘤大多有较典型的影像学及病理组织学表现，CT和MR检查对术前准确诊断有较高价值。 |
| 关键词: 卵巢肿瘤 硬化性间质瘤 病理学 CT 磁共振成像 |
| DOI： |
| 分类号: |
| 基金项目:浙江省教育厅科研基金项目 |
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| CT and MR features and histopathological characteristics of ovarian sclerosing stromal tumor |
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WANG Zhitao,ZOU Yu,LI Kui
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Hangzhou Third People's Hospital
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| Abstract: |
| Objective To investigate CT and MR manifestations and histopathological characteristics of ovarian sclerosing stromal tumor (OSST). Methods CT and MR images and histopathological results of 30 cases of OSST were analyzed retrospectively. Results Unilateral ovarian involvement was seen in all 30 cases, including 18 cases located in the right ovary and 12 located in the left. The tumors size varied from 1.5~12.3 cm in the longest diameter. Twelve cases presented homogeneous solid masses and 18 cases presented cystic-solid mixed masses, and the latter showed "lake-island sign" on T2WI. Three types of
enhancement pattern were presented on contrast-enhanced CT or MR scan: ① rapid strong enhancement in the peripheral area
in the arterial phase followed by centripetal enhancement in the venous phase, similar to "hepatic cavernous hemangioma" (16 cases). ② strong homogeneous enhancement in the whole mass followed by progressive enhancement (10 cases). ③ mild enhancement followed by progressive enhancement, which were lower than ① and ② (4 cases). Pathologic examination demonstrated pseudolobule patterns, signet-ring cells, collagenous areas, edematous hypocellular areas and prominent vasculatures. Immunohistochemical analysis revealed that all 30 cases presented positive expression of vimentin, SMA and PR, and negative expression of CK, EMA, and s-100. Conclusion Most of CT or MRI manifestations and pathologic findings of OSST are characteristic, indicating that preoperative CT or MRI examination can make appropriate diagnosis when combined with clinical information. |
| Key words: Ovarian neoplasm Sclerosing stromal tumor Pathology CT Magnetic resonance imaging |
