CAJ | 학술논문

目的：探讨卵巢原发非上皮源性肿瘤的 CT、MRI 表现及其诊断价值。方法回顾性分析行多层螺旋 CT 及/或1．5T MRI 平扫及动态增强扫描并经手术病理证实的性索间质肿瘤12例、生殖源性肿瘤17例共29例32个卵巢非上皮源性肿瘤的 CT、MRI 特征。结果性索间质肿瘤中，颗粒细胞瘤及卵泡膜细胞瘤以实性为主，颗粒细胞瘤伴小囊变且多位于周边，增强扫描实性部分轻度强化。两性母细胞瘤囊实性相间呈“蜂巢”状改变，增强后实性部分轻、中度强化。硬化性间质瘤呈周边实性、中央大片囊变，MRI 动态增强扫描早期周边明显强化，随时间延长造影剂渐进性向中央填充。生殖源性肿瘤中，成熟型畸胎瘤及未成熟畸胎瘤呈脂肪、钙化、软组织混杂密度/信号，成熟型畸胎瘤各成分间分界清晰，未成熟型畸胎瘤各成分间分界模糊。MRI 显示少量脂肪较 CT 敏感， CT 对小钙化检出率较 MRI 高，二者增强扫描软组织成分轻度强化。甲状腺肿呈多房囊性为主肿块，可见点、条状钙化。MRI 示囊腔信号高低不等，房隔及壁呈等/稍高信号，增强后房隔及壁显著强化。无性细胞瘤呈较大实性为主肿块，MRI T2WI 示稍高信号，肿块内见线状稍低信号影，增强后肿块轻度强化，线状影明显强化。卵黄囊瘤 CT平扫呈囊实性，中央大片囊变区，增强后病灶周边及内部见多发显著强化血管影。结论MRI 检查应作为卵巢原发非上皮源性肿瘤的优选影像检查方法。多数卵巢原发非上皮源性肿瘤影像表现有一定特征，结合临床及生化检查可作出定性诊断。
목적：탐토란소원발비상피원성종류적 CT、MRI 표현급기진단개치。방법회고성분석행다층라선 CT 급/혹1．5T MRI 평소급동태증강소묘병경수술병리증실적성색간질종류12례、생식원성종류17례공29례32개란소비상피원성종류적 CT、MRI 특정。결과성색간질종류중，과립세포류급란포막세포류이실성위주，과립세포류반소낭변차다위우주변，증강소묘실성부분경도강화。량성모세포류낭실성상간정“봉소”상개변，증강후실성부분경、중도강화。경화성간질류정주변실성、중앙대편낭변，MRI 동태증강소묘조기주변명현강화，수시간연장조영제점진성향중앙전충。생식원성종류중，성숙형기태류급미성숙기태류정지방、개화、연조직혼잡밀도/신호，성숙형기태류각성분간분계청석，미성숙형기태류각성분간분계모호。MRI 현시소량지방교 CT 민감， CT 대소개화검출솔교 MRI 고，이자증강소묘연조직성분경도강화。갑상선종정다방낭성위주종괴，가견점、조상개화。MRI 시낭강신호고저불등，방격급벽정등/초고신호，증강후방격급벽현저강화。무성세포류정교대실성위주종괴，MRI T2WI 시초고신호，종괴내견선상초저신호영，증강후종괴경도강화，선상영명현강화。란황낭류 CT평소정낭실성，중앙대편낭변구，증강후병조주변급내부견다발현저강화혈관영。결론MRI 검사응작위란소원발비상피원성종류적우선영상검사방법。다수란소원발비상피원성종류영상표현유일정특정，결합림상급생화검사가작출정성진단。
Objective To investigate the CT and MRI findings and their diagnostic value of primary non-epi-thelial ovarian tumors.Methods Thirty-two primary non-epithelial ovarian tumors included 12 sex cord-stromal tumor and 17 Germ Cell Origin tumor had been scaned by multi-slice spiral CT and/or 1.5T MRI plain and dynamic enhanced and proved by surgery and pathology were reviewed retrospectively and the CT/MR characteristics were analyzed.Results Granular cell tumor and theca cell tumorpresented as mostly solid in sex cord-stromal tumor,while granular cell tumor mostly accompanied with some small cysts on rims,Dysgerminoma presented as tumor with mostly solid component,at MRI,the tumors were hyperintensity on T2WI and low intensity thread-like inside the tumor.After Gadolinium was infused, solid showed mild enhancement,the thread-like was significant enhanced."honeycomb"with cystic and sol-id,and solid slightly enhanced on contrast-enhanced images.Sclerosing stromal tumor display as peripheral solid mass and large piece of cystic area in center,after dynamic MRI scaning the solid showed significant enhanced in the early stage and progressive increase on the delayed phase.In the tumors of Germ Cell Ori-gin,immature teratom and mature teratoma showed as mixed density or signal with fat and calcification and soft tissue.Different components are clearly identified in the former,but the latter are not.MRI had more sensitive for displaying a little fat than CT,while show the small calcification CT is better than MRI. Soft tissue components of two types of tumors were mild enhancement.Struma-ovarii Dysgerminoma pres-ented as tumor with mostly solid component,at MRI,the tumors were hyperintensity on T2WI and low intensity thread-like inside the tumor.After Gadolinium was infused,solid showed mild enhancement,the thread-like was significant enhanced.presented as tumor with mostly solid component,at MRI,the tumors were hyperintensity on T2WI and low intensity thread-like inside the tumor.After Gadolinium was in-fused,solid showed mild enhancement,the thread-like was significant enhanced.Yolk sac tumor CT scan showed cystic-solid components and large cystic areas in the central,after enhancing,there are multiple significantly enhanced vessels in the interior and peripheral of lesions.Conclusion MRI is the prior imaging examination method of primary non-epithelial ovarian tumors.The majority of primary ovarian non-epithelial tumors imaging had some characteristic features,and combined with clinical and biochemical examination can make a qualitative diagnosis.