卵巢囊性腺纤维瘤MR特征及病理分析

目的：探讨卵巢囊性腺纤维瘤的MRI表现特征及病理学基础,提高对该疾病的诊断准确性。方法收集并回顾性分析14例经手术病理证实的卵巢囊性腺纤维瘤患者MRI资料,所有患者术前均行MR平扫及增强扫描。重点对病变内部结构、信号特征及增强表现进行分析归纳,明确其具有诊断价值的图像特征。结果本组13例病灶为单侧发病,1例为双侧发病。病灶最大径为3．4-14．8cm,平均约8．15cm;8例呈囊性（多囊者6例,单囊者2例）,5例呈囊实性,1例呈实性。8例囊性病变于MRI-T2WI囊壁及分隔呈低信号;囊实性病灶实性成份主要表现为低信号,其中并见多发小囊样高信号灶,其中2例形成较典型的“黑色海绵征”。MR增强扫描所有病灶实性成份及囊壁均呈中度或明显强化效应。结论卵巢囊性腺纤维瘤多为单侧发病,主要呈多囊性表现;肿瘤中实性成份及囊壁T2WI呈低信号,增强扫描呈轻中度强化。“黑色海绵征”是其较典型的特征表现。     

卵巢浆液性囊性腺纤维瘤MR诊断及病理分析

目的探讨卵巢浆液性囊性腺纤维瘤的磁共振(MRI)特征表现及病理学基础,提高对该病的诊断水平。方法回顾性分析经病理证实的21例卵巢浆液性囊性腺纤维瘤患者的MRI影像资料,所有患者术前均行MR平扫及增强扫描,对病灶内部结构、信号特征及增强表现进行分析。结果 2例患者为双侧发病,19例为单侧发病,共23个病灶。病灶最大经为33~159mm,平均82.7mm;7个为囊实性,16个为囊性,其中单囊4个,多囊12个,有6个含有壁结节。所有病灶囊壁、分隔及实性成份在MRI-T_2WI呈低信号,5个囊内壁局部增厚,呈"地毯征";4个囊实性病灶中实性成份见小囊样高信号影,形成"黑色海绵征"。增强扫描17个病灶实性成份及囊壁呈轻中度强化,6例未见强化。结论卵巢浆液性囊性腺纤维瘤中囊壁及实性成份T_2WI呈低信号,增强扫描大部分呈轻中度强化;"地毯征"及"黑色海绵征"是其特征表现。     

卵巢内外浆液性囊腺纤维瘤的超声检查特征分析

目的探讨卵巢内、外浆液性囊腺纤维瘤(ovarion serous cystadeofibroma, OSCAF)的超声声像图特征。方法选取经手术病理确诊的28例卵巢内与23例卵巢外SCAF的临床及超声资料,分析超声特点。结果卵巢内组好发于年长及绝经后妇女,卵巢外组好发于育龄期女性,两组超声表现相似,均为囊性多见,其中单纯囊性和囊性含乳头为最常见型,乳头突起内一般无血流信号。阴影征是超声特异性表现。合并症复杂多样,术前误诊率高,不同表现的SCAF需要与不同类型的卵巢肿瘤相鉴别。结论超声检查可以为卵巢内、外SCAF的诊断和鉴别诊断提供重要信息。     

卵巢囊腺纤维瘤的CT表现

目的：探讨卵巢囊腺纤维瘤(CAF)的 CT 特征,提高对该病的诊断水平。方法回顾性分析病理证实的7例卵巢 CAF患者的临床及 CT 资料,7例均行 CT 平扫、增强检查。结果本组5例单侧发病,2例双侧发病,共9个病灶,6个为囊性,2个为实性,1个为囊实性。病灶长径为4.7~21.5 cm,平均为8.2 cm。病灶边缘光滑,实性部分可见多个大小不等的囊泡,局部囊壁或分隔均有不同程度的增厚,1个病灶增厚的囊壁内可见钙化,5个病灶可见壁结节,其中1个壁结节内可见小囊泡。囊性部分呈低密度,无强化;实性部分、增厚囊壁及分隔、壁结节呈均匀轻度强化或不强化。腹盆部均未见淋巴结转移,未见腹腔积液,腹膜及网膜未见种植转移。结论卵巢 CAF 具有一定的 CT 特征,可以为临床诊断与鉴别诊断提供帮助。     

卵巢浆液性囊腺瘤的CT诊断分析

目的探讨卵巢浆液性囊腺瘤的CT表现,提高对该病的认识。方法回顾性分析17例经病理证实的卵巢浆液性囊腺瘤临床资料,17例均行CT平扫,9例作CT增强扫描检查,17例均行手术治疗。结果良性浆液性囊腺瘤14例,其中13例CT表现为大小不一的囊性包块;交界性浆液性囊腺瘤或恶性变3例,囊内可见多个乳头状突起或囊壁的明显增厚,术前误诊2例,正确诊断15例。结论良性浆液性囊腺瘤有明显的特征性的CT表现,交界性或恶性变浆液囊腺瘤具有一定的CT表现。     

双侧卵巢囊性腺纤维瘤一例

卵巢囊性腺纤维瘤少见,双侧发生更罕见。现报道一例如下。病例资料　患者,女,5 1岁。以右下腹不适半月就诊,平时月经规则,白带无异常,无尿频、尿急。妇科检查:左右下腹各扪及一实性包块,边界清,活动可,无压痛。B超示盆腔多发实性占位。CT示左、右卵巢区各有一分叶状软组织肿块,     

卵巢纤维瘤的CT及MRI诊断

目的:探讨螺旋CT、MRI对卵巢纤维瘤的诊断价值。方法:回顾性分析经手术病理证实的8例卵巢纤维瘤CT、MRI征象,7例行CT扫描,1例行MRI检查。结果:8例患者均表现为盆腔内单侧边界清楚的肿块,其表现可分为三类:单纯肿块型5例,1例小肿瘤密度均匀,4例大的肿瘤密度不均匀,增强后肿瘤不强化或轻度强化;囊变型2例,肿瘤内见囊性密度及信号影;合并其他肿瘤型,1例合并同侧卵巢粘液性囊腺瘤。结论:卵巢纤维瘤CT、MRI表现呈多样化,动态增强扫描可提高诊断符合率。     

卵巢纤维瘤的CT诊断

目的 探讨卵巢纤维瘤的CT影像特点,提高术前诊断准确率.方法 回顾性分析9例经手术病理证实的卵巢纤维瘤的CT表现及临床资料.结果 9例均表现为单侧附件肿块,大小约4.8 cm×4.0 cm×3.6 cm～17.5 cm×16.0 cm×11.7 cm.4例(44.4％)呈圆形或类圆形,4例(44.4％)呈分叶状,1例(11.1％)形态不规则.8例(88.9％)边界清楚,与子宫分界清楚.8例(88.9％)表现为不均匀实性包块伴不规则坏死区.增强扫描9例中有8例为无或轻度强化(强化幅度约0～10 HU),1例(11.1％)呈不均匀结节状明显强化.5例合并腹水,其中1例为大量腹水.结论 卵巢纤维瘤CT表现有一定特征,常表现为单发的边界清楚的实性包块,可有囊变、坏死及钙化等,增强扫描多为无或轻度强化.合并腹盆腔积液时需与卵巢恶性肿瘤鉴别.     

卵巢囊性腺纤维瘤CT及MRI表现

目的：探讨卵巢囊性腺纤维瘤的CT及MRI表现特点,提高对该病的诊断水平。方法：回顾性分析11例经手术病理证实的卵巢囊性腺纤维瘤患者的CT及MRI资料,其中9例行CT平扫及增强扫描,2例行MRI平扫。结果：本组11例中6例呈囊性,5例呈囊实性。囊性病灶与卵巢囊腺瘤的影像表现无法鉴别。3例囊实性病灶在CT增强后于实性区内可见多发小囊样无强化区,呈＂筛孔样＂改变。2例囊实性病灶于MRI T2加权呈低信号的实性部分内可见多发小囊样、索条状高信号,形成＂黑色海绵征＂。结论：＂筛孔征＂及＂黑色海绵征＂是卵巢囊性腺纤维瘤的影像特征,有助于其诊断与鉴别诊断。     

膀胱纤维瘤一例

膀胱纤维瘤一例张在沛患者男性，３７岁。小便不畅，时有中断２年余，伴下腹坠胀，偶有尿痛，无尿频、尿急。入院体检：腹平软，双肾区无叩击痛，膀胱区压痛，未扪及包块。分泌性尿路造影检查：双肾功能正常，膀胱内良性占位性病变。Ｂ超检查：膀胱内新生物。ＣＴ检查：平...     

Macrocystic serous adenoma of the pancreas: radiologic-pathologic correlation

OBJECTIVE: Macrocystic serous adenoma is a rare benign pancreatic neoplasm, recently described in the pathology literature. We describe the CT and MR imaging features in a series of five consecutive pathologically proven cases. MATERIALS AND METHODS: Of seven cases fulfilling the pathology criteria for macrocystic serous adenoma over an 11-year period, five patients underwent preoperative CT and MR imaging at our institution. In addition to the clinical presentation and pathologic features of the tumor, the following CT and MR imaging features were reviewed: size and location; wall thickness; internal septations; and presence of mural nodules, papillary projections, or calcifications. RESULTS: All patients but one were women (age range, 36-78 years; mean age, 48.6 years). The sizes of the tumors ranged from 1.5 to 5.0 cm (mean, 3.1 cm). Three (60%) of five tumors were located in the pancreatic head. The wall measured less than 2 mm in four lesions and 4 mm in one. No mural nodules, papillary projections, or calcifications were present. Lesions were unilocular (n = 3) or bilocular (n = 2). Excellent correlation of imaging features with gross pathology was observed. CONCLUSION: On CT and MR imaging, the macrocystic variant of serous adenoma typically appears as a small (< 5 cm), uni- or bilocular cyst with a thin (< 2 mm) wall that lacks mural nodules or calcifications. The imaging appearance of macrocystic serous adenoma is distinctly different from that of microcystic serous cystadenoma, but the imaging appearance of macrocystic serous adenoma is indistinguishable from mucinous cystadenoma and cystadenocarcinoma of the pancreas.     

Computed tomography of benign ovarian masses

Although ultrasound is the primary imaging modality for evaluating benign gynecologic pelvic masses, CT may provide diagnostic information regarding ovarian masses that are discovered fortuitously. The relatively infrequent use of CT in evaluating the adnexa has resulted in a paucity of literature regarding the CT characteristics of benign ovarian masses. The CT appearances of 24 benign ovarian masses are presented. Pathologic diagnoses were ovarian cyst (nine), endometrioma (five), teratoma (three), serous cystadenoma (two), mucinous cystadenoma (two), thecoma (one), cystadenofibroma (one), and Brenner tumor (one). Benign ovarian cysts have characteristic homogeneous water density and smooth walls on CT. Single internal septations and slight wall irregularity are also common features, but soft-tissue mural or septal nodules are uncommon. Computed tomography can be diagnostic in evaluating cystic teratomas. Other benign ovarian masses exhibit a spectrum of CT appearances that is often nonspecific, and surgical or biopsy proof may be necessary to exclude malignancy.     

Epithelial tumors of the ovary: comparison of MR and CT findings

Forty patients with 50 ovarian epithelial tumors of the ovary were retrospectively studied. They underwent computed tomography and magnetic resonance (MR) imaging within 1 week of surgery. MR examinations were performed with a superconducting magnet (0.5 T) and predominantly T1- and T2-weighted MR imaging. T1-weighted MR images were obtained in eight patients after contrast material was administered. Signal intensity of tumors was compared with that of urine, muscle, and fat. Morphologic features that were evaluated included size, vegetations, septations, wall thickness, fluid or solid components, and vascularity. On the basis of signal intensity and morphologic characteristics, MR imaging helped in the correct diagnosis of benign serous cystadenoma in 10 of 13 tumors, benign mucinous cystadenoma in seven of 10 tumors, and tumors of low malignant potential and malignant tumors in 23 of 27 tumors. Accuracy for overall characterization of benign versus malignant tumors was 86% with MR imaging and 92% with computed tomography. There was no difference in sensitivity (P = 1) or specificity (P = .5).     

卵巢良性病变的CT表现

目的 提高对卵巢良性病变ＣＴ表现的认识。材料与方法 回顾性分析经手术病理证实的６６例共８０个卵巢良性肿块的ＣＴ及Ｂ超资料,讨论其ＣＴ表现特点及ＣＴ在诊断中的作用。结果 本组２５个功能性囊肿ＣＴ发现２３个;１８个卵巢子宫内膜异位囊肿,长径多与同侧的盆壁近科平行（１２／１８）,甚至大于横径达１．５倍（９／１８）;１５个囊腺瘤均呈边缘光滑的囊性肿块,其中浆液性囊腺瘤（ｎ＝９）密度均匀,多为单房（６／９）     

卵巢肿瘤的CT诊断

目的：提高对卵巢肿瘤ＣＴ表现的认识及诊断。方法：详细分析了４２例经病理证实的卵巢肿瘤的ＣＴ表现。结果：（１）非赘生性囊肿和囊腺瘤的特征为薄壁的囊性肿物，壁与间隔薄且规则。ＣＴ可识别囊内新近出血。（２）肿物内含脂肪成份，囊壁隆起的实性结节处见结节状钙化或牙齿是囊性畸胎瘤定性诊断的特征性表现。（３）恶性囊性肿瘤的特征为囊壁与间隔不规则增厚，其内可发现乳头状或不规则实性成份。结论：ＣＴ是诊断本病的重要的影像学检查手段。结合临床综合分析，有助于提高诊断准确性。     

Computed tomography and magnetic resonance imaging findings in cases of dermoid cyst coexisting with surface epithelial tumors in the same ovary

OBJECTIVE: The purpose of this work was to describe the computed tomography (CT) and magnetic resonance imaging (MRI) findings in cases of dermoid cysts coexisting with surface epithelial tumors in the same ovary. METHODS: The pathologic reports of 141 dermoid cysts, 97 mucinous and 35 serous tumors were reviewed. The CT and/or MR images in the cases with a dermoid cyst and a surface epithelial tumor coexisting in the same ovary were analyzed. RESULTS: Eleven cases of mucinous tumors (6 benign, 3 low-grade, and 2 malignant) coexisted with dermoid cysts. Mucinous tumors were found in coexistence with 11.3% of dermoid cysts, and dermoid cysts were found in coexistence with 7.8% of mucinous tumors. In 10 cases, 3 radiologic patterns were observed: small fatty foci in the septa of the cystic tumor, an adjacent fat-containing component and a septated cystic component, and a dermoid cyst with no detectable mucinous tumor component. No histopathologically specific differences were observed between these groups. Small amounts of mucinous components were difficult to detect, but small fatty foci were easily detected. In 1 case, mucinous carcinoma formed a mass lesion in the wall of the dermoid cyst. CONCLUSIONS: The coexistence of these two neoplasms was not rare. If a dermoid cyst accompanies a multiseptated cyst and if the multiseptal cyst contains fatty foci, these two components may be associated. Recognizing the potential for the coexistence of these two neoplasms in the same ovary is essential for making a correct diagnosis.     

False-positive I-131 uptake by an ovarian serous cystadenofibroma

We present the case of a 53-year-old woman after thyroidectomy with metastatic multifocal papillary carcinoma and encapsulated focal Hurthle cell carcinoma. Postoperatively, an I-131 whole-body scan revealed uptake in the low midline anterior neck. She was treated with 151.5 mCi of I-131. The 1-year follow-up I-131 whole-body scan revealed a new pelvic mass with I-131 uptake. Pelvic CT showed bilateral complex ovarian masses. She underwent surgical excision, revealing a right ovarian endometriotic cyst and a left ovarian cystadenofibroma, without thyroid tissue involvement. I-131 uptake in a cystadenofibroma is extremely rare and has been reported only once to our knowledge.     

Cystic teratoma of the ovary: CT detection

Computed tomography (CT) was performed in 38 patients with 41 benign cystic teratomas of the ovary and two patients with malignant transformation. CT depicted all tumors. The presence of fat in 40 of 43 cases (93%), tooth or calcification in 24 of 43 (56%), Rokitansky protuberance in 35 of 43 (81%), tufts of hair in 28 of 43 (65%), and a fat-fluid level in five of 43 (12%) allowed a definite diagnosis of ovarian cystic teratoma in 42 of 43 cases (98%). In the two cases of malignancy, single large (greater than 10 cm) plugs (with uptake of contrast medium in one) with a cauliflower appearance and an irregular border forming an obtuse angle with the inner wall of the cyst suggested malignant transformation. In three cases of benign cystic teratoma, a mucinous tumor (one benign, one borderline, one malignant) arising in the same ovary was seen at pathologic examination but was only diagnosed with the help of CT in two of three cases. Thickening of the tube was noted in two cases of torsion of the adnexa. CT findings were compared with findings at radiography of the abdomen and hysterosalpingography in 30 cases, ultrasound in 31, and magnetic resonance imaging in three. This study demonstrated that CT was the best procedure for imaging cystic teratomas of the ovary.     

Ovarian serous surface papillary borderline tumors form sea anemone-like masses

Purpose

To clarify the imaging characteristics of ovarian serous surface papillary borderline tumor (SSPBT), whose prognosis is far better than that of serous surface papillary adenocarcinoma (SSPC).

Materials and Methods

We retrospectively reviewed the clinical and imaging findings of six cases (age range, 26–58 years; mean, 43 years) with SSPBT encountered at our institute from 1996 to 2008.

Results

Serum levels of CA125 were elevated, and they were clinically suspected to have ovarian cancer. All masses were almost entirely solid and showed hyperintense papillary architecture with hypointense internal branching on T2‐weighted MRI. Five patients had peritoneal implants, and two had lymph node enlargement, and all tumors were accompanied by ascites. In all cases, contralateral ovaries had cystic masses with mural nodules or mixed solid and cystic masses, of which the solid part was similar to the contralateral mass. No evidence of recurrence was noted at a follow‐up of >12 months postoperatively.

Conclusion

SSPBT, which has more favorable prognosis than those of flank ovarian carcinoma, is characterized by a solid mass with papillary architecture and internal branching resembling a sea anemone on MR. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.