卵巢硬化性间质瘤3.0T MRI表现征象分析(附2例报告)

目的探讨卵巢硬化性间质瘤(sclerosing stromal tumor of ovary,SST)的3.0T MRI平扫、扩散加权成像及动态增强信号表现,提高对本病的影像学征象的认识。方法回顾性分析经手术病理证实的2例SST的MRI平扫、DWI和动态增强的影像学表现。采用GE HDxt 3.0T超导MR机,在常规平扫序列的基础上,重点观察LAVA-Flex多期、多平面动态增强和高b值DWI(b=1000 s/mm2)及ADC图的影像学表现。结果 2例卵巢硬化性间质瘤均发生于左侧卵巢;T1WI、T2WI和T2WI FS均表现为卵巢椭圆形囊实性混杂信号肿块,自外向内依次显示低信号包膜、中等信号的实性成分和水样信号的囊变区;在低信号包膜及实性成分周围有多根细小的流空的肿瘤血管;高b值的DWI上肿块实性成分呈高信号,2例SST的平均ADC值分别约为1.79×10-3mm2/s及1.74×10-3mm2/s;MR动态增强:动脉期肿块边缘的实性成分呈乳头状或梳齿状明显强化,静脉期强化自边缘向中心扩散,延迟期病变持续强化,强化范围扩大,呈"快进慢出"的强化。结论 3.0 T MRI可以更好反映卵巢硬化性间质瘤的病理形态学和水分子扩散等多种影像学征象,仔细识别其特征性MRI征象,可提高本病的正确诊断率。

The Analysis of 3.0T MRI Characteristic Findings of the Ovarian Sclerosing Stromal Tumor (2 Cases Report)

Objective To investigate diffusion weighted imaging and dynamic enhancement findings of the ovarian sclerosing stromal tumor(SST) with 3.0T MRI , in order to improve the accuracy of SST. Methods The manifestation of MRI plain scanning,DWI and dynamic enhancement of 2 patients with pathologically proven ovarian SST were retrospectively analyzed, with a focus on the multiple phases and planes LAVA - Flex dynamic enhancement , DWI with high b value (b value is 1000 s/mm2) and ADC imaging features base on the conventional unenhanced sequences, with GE HDxt 3.0T superconductive MRI. Results 2 cases SSTs were originated from the left ovarits. They were oval-shaped cystic and solid tumors with mixed signal intensities at T1-weighted imaging, T2-weighted imaging and fat-suppressed T2-weighted imaging, which showed from the outer to the inner in turn:low signal intensities rims, the solid components with medium signal intensities ,and the cystic components with the same signal intensities as water. Multiple tiny flow voids tumor vessel could be seen around the rims and solid components. The solid components of tumors displayed the high signal intensities in the high b value DWI, and the average ADC value of 2 cases were 1.79×10-3mm2/s and 1.74×10-3mm2/s respectively. Dynamic contrast-enhanced MR imagings showed the edge solid components of tumors have obviously been enhanced with the shape of papilla or comb at arterial phase, and the venous phase enhancement got diffusion from the edge to the center, delayed phase lesions had continuous enhancement whose ranges were expanded with feature of"Rapid entry and Delayed Exit"on the whole. Conclusion 3.0 T MRI can better reflect the pathomorphism and multiple imaging features such as the hydrone diffusion of SST. Attentively identify MRI characteristic findings of SST can improve correct diagnosis rate of SST.