卵巢透明细胞癌的CT及MRI影像学特征

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摘要目的：总结卵巢透明细胞癌（OCCC）的CT及MRI影像学特点，以提高对该病的认识。方法：分析经手术病理证实的25例OCCC患者的CT及MRI影像表现，其中17例行CT平扫及增强扫描，8例行MRI平扫及增强扫描。结果：25例患者病灶均位于单侧，其中右侧16例，左侧9例，最大径为7.2～16.5 cm，21例病灶呈类圆形，4例病灶边缘呈分叶状，2例包膜不完整；18例病灶表现为单囊内较大的单发或多发实性结节，呈“单囊大结节”的表现，7例肿块内可见纤维分隔。肿瘤实性成分分布具有一定特点：25例中有18例呈偏侧分布（占72%），其中位于肿瘤来源侧侧壁5例、侧后壁8例、来源侧侧壁及前后壁5例；2例位于肿瘤后壁，5例实性成分呈广泛分布。CT平扫囊性成分CT值为13～26 HU，实性成分CT值为31～52 HU；MRI检查T1WI上囊性成分信号多样，可为低、等、高信号，T2WI上囊性成分均为高信号，实性成分T1WI上为低信号，T2WI上为稍高信号，DWI为高信号；CT及MRI增强囊性成分无明显强化，实性成分及纤维分隔明显持续强化，并可见包膜的延迟强化；有9例一侧卵巢动静脉血管增粗及分支增多。结论：OCCC的影像表现具有一定特征性，结合临床表现有助于定位定性诊断。

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	宋慧玲
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关键词 ：卵巢肿瘤；腺癌, 透明细胞；体层摄影术, 螺旋计算机；磁共振成像

Abstract：Objective: To improve the recongnition of CT and MRI in diagnosing ovarian clear cell carcinoma. Methods: The CT and MRI features in 25 ovarian clear cell carcinoma (OCCC) patients were analyzed. 17 patients underwent pre- and post-contrast CT scans, 8 patients underwent pre-and post-contrast MRI scans. Results: Unilateral mass was revealed in all 25 cases, which localized at the right side in 16 cases, left side in 9 cases. The maximum diameter of the mass ranged from 7.2 to 16.5 cm. The tumors appeared as the roundly well-defined mass in 21 cases, the lobulated mass in 4 cases, incomplete capsule in 2 cases. 18 cases appeared as a single cyst with single or multiple large solid nodules, namely “a single capsule with large nodule”. And the fibrous septa were found in 7 cases. The distribution of solid component had certain characteristics: Among the 25 cases, 18 cases were unilateral distribution (72%), which was located in the source side of the side wall in 5 cases, 8 cases in the posterior wall, 5 cases in the side wall, anterior and posterior walls; 2 cases of tumor located in the posterior wall, 5 cases of solid component was widely distributed. CT value of cystic part of the mass was 13-26 HU, while solid part was 31-52 HU. The cystic component showed heterogenous signal intensity on T1WI, high signal intensity on T2WI. The solid component showed low signal intensity on T1WI, slightly high signal intensity on T2WI, and restricted diffusion on DWI. On post-contrast CT and MRI images, the solid and septa component showed marked and delayed enhancement, while the cystic component showed no enhancement. 9 cases showed the enlarged ipsilateral ovarian arteriovenous and increased branches. Conclusion: CT and MRI appearance of OCCC can help improve the diagnostic ability of this rare disease.

Key words： ovarian neoplasm adenocarcinoma, clear cell tomography, spiral computed magnetic resonance imaging

收稿日期: 2016-11-24

通讯作者: 严志汉，教授，主任医师，Email：yanzhihanwz@163.com

作者简介: 宋慧玲（1985-），女，山东临沂人，主治医师，在职硕士生

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I7/523

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