卵巢透明细胞癌与成人型卵巢颗粒细胞瘤的CT、MRI鉴别诊断

CT and MRI Differential Diagnosis of Ovarian Clear Cell Carcinoma and Adult-Type Ovarian Granulosa Cell Tumor

摘要: 目的：比较卵巢透明细胞癌(OCCC)与成人型卵巢颗粒细胞瘤(OGCT)的CT、MRI表现，探讨CT、MRI对两者的鉴别价值。方法：回顾性分析有完整CT或MRI检查资料并经术后病理证实的OCCC和成人型OGCT各8例。结果：16例患者15例单侧发病，1例OCCC双侧卵巢同时发病。8例OCCC共9个病灶均为囊实性，8个囊性为主，1个实性为主，病灶实性成分呈结节、乳头状附壁生长向腔内凸起6个，形成肿块偏侧生长呈“冰山征”3个，增强后多呈中度持续性强化。成人型OGCT囊实性病灶7个，完全实性1个，5个较大肿瘤实性成分内见“裂隙样”或“海绵状”小囊变区，2个囊性为主病灶实性成分呈“飘带状”散在囊腔，增强后实性成分多呈中度延迟强化。结论：CT、MRI可很好地显示OCCC与成人型OGCT不同的囊实性改变及实性部分增强特点，有助于两者的鉴别诊断。

Abstract: Objective: To compare CT and MRI features of ovarian clear cell carcinoma (OCCC) and adult-type ovarian granulosa cell tumor (OGCT), and to investigate the differential value of CT and MRI. Meth-ods: 8 cases of OCCC and 8 cases of adult-type OGCT confirmed by pathology were collected, in which CT or MRI findings were analyzed retrospectively. Results: 15 unilateral cases and 1 bilateral OCCC case were detected in 16 patients. A total of 9 lesions in 8 cases of OCCC were cystic solid mixed, with 8 lesions cystic predominant and 1 lesion solid predominant. The solid components of the 6 lesions were forming nodular, papillary and protruded into the capsule, of 3 lesions were forming bump lateral growth “iceberg signs”, and most of them showed moderate and continuously enhancing af-ter enhancement. 7 cases were cystic solid mixed and 1 was complete solid in 8 cases of adult-type OGCT, 5 large masses showed “crack-like” or “sponge-like” small cystic areas in solid components, the solid components of the 2 cystic predominant lesions are scattered in the cyst cavity, and the solid components after enhancement are mostly moderately delayed. Conclusion: CT and MRI can well show the different cystic and solid changes and solid partial enhancement characteristics be-tween OCCC and adult-type OGCT, which is helpful for the differential diagnosis of them.