CAJ | 학술논문

目的：探讨卵巢颗粒细胞瘤的MRI及CT特点，提高诊断与鉴别诊断能力。方法回顾性分析12例经手术病理证实的卵巢颗粒细胞瘤MRI及CT表现，并与病理对照，总结其MRI及CT特征。结果12例肿瘤均为单侧，类圆形，包膜完整的囊实性肿块。其中11例行MR平扫，实性部分呈等/稍长T1稍长T2信号；1例行CT检查、呈等密度影。肿瘤内含较多囊腔，小囊呈“蜂窝状”或“海绵状”，较大的囊腔囊壁和间隔厚而均匀。9例肿瘤部分囊腔内含血性信号/密度。增强扫描肿瘤实性部分明显强化，MRI平均信号强度略低于子宫肌层(病变信号值约为476.10±73.33，子宫肌层信号值为505.73±64.99)。所有患者子宫内膜均有不同程度增厚。大体病理标本切面与MRI/CT表现相符合，12例肿瘤部分囊腔内均见暗红色血液或血凝块。病理诊断：10例为成年型卵巢颗粒细胞瘤，其中低分化3例，2例腹膜、肠壁、输卵管见转移灶；中分化2例。2例为幼年型颗粒细胞瘤。子宫内膜均为增生期改变，部分患者见息肉、子宫内膜癌。结论卵巢颗粒细胞瘤的MRI/CT具有一定特征，结合性激素所致的临床症状，能明确诊断。
목적：탐토란소과립세포류적MRI급CT특점，제고진단여감별진단능력。방법회고성분석12례경수술병리증실적란소과립세포류MRI급CT표현，병여병리대조，총결기MRI급CT특정。결과12례종류균위단측，류원형，포막완정적낭실성종괴。기중11례행MR평소，실성부분정등/초장T1초장T2신호；1례행CT검사、정등밀도영。종류내함교다낭강，소낭정“봉와상”혹“해면상”，교대적낭강낭벽화간격후이균균。9례종류부분낭강내함혈성신호/밀도。증강소묘종류실성부분명현강화，MRI평균신호강도략저우자궁기층(병변신호치약위476.10±73.33，자궁기층신호치위505.73±64.99)。소유환자자궁내막균유불동정도증후。대체병리표본절면여MRI/CT표현상부합，12례종류부분낭강내균견암홍색혈액혹혈응괴。병리진단：10례위성년형란소과립세포류，기중저분화3례，2례복막、장벽、수란관견전이조；중분화2례。2례위유년형과립세포류。자궁내막균위증생기개변，부분환자견식육、자궁내막암。결론란소과립세포류적MRI/CT구유일정특정，결합성격소소치적림상증상，능명학진단。
Objective To evaluate the MRI and CT characteristic manifestations of ovarian granulosa cell tumor and to promote the diagnostic and differential diagnostic ability. Methods The MRI and CT data of twelve patients with ovarian granulosa cell tumors which confirmed by histopathology were analyzed retrospectively, and then compared with pathology to summarized the MRI and CT characteristic manifestations. Results A total of 12 cases were cystic-solid mass, unilateral, rough circular and with complete capsule. 11 of 12 cases had MRI scan, and the solid part showed middle or mild low signal on T1WI and mild high signal on T2WI. 1 case with CT scan and showed soft tissue density. The cystic part showed polycystic that little cysts had "honeycomb-like"or "spongy" appearances and large ones had thick, regular septations. Blood singal or density could be found in the cyst in 9 cases. The solid part and the septations of tumors were obviously enhanced after injecting contrast agent. The signal intensity enhanced was 476.10±73.33 which was lower than uterus muscle (signal intensity was 505.73±64.99). There were different degree of endometrial hyperplasia in 12 patients. Pathological structures of 12 cases were consistent with MRI or CT manifestations that haemorrhage or cruor block in cysts of all tumors. The pathological diagnosis prompted that 10 cases were adult ovarian granulosa cell tumor, 2 cases were middle tissue differentiation, 3 cases low tissue differentiation in which tumor metastasis happened in peritoneum, intestinal wall and fallopian tube in 2 cases. The endometrial hyperplasia were seen in all cases, and some patients combined polyps or carcinoma. Conclusions It's possible to make a correct diagnosis by combined the MRI and CT characteristic with clinical symptom.