卵巢颗粒细胞瘤的超声影像与病理对照分析

目的探讨超声检查在诊断卵巢颗粒细胞瘤(OGCT)中的应用价值。方法回顾性分析38例经手术病理证实为卵巢颗粒细胞瘤且临床资料完整的患者,对患者子宫、卵巢行多切面仔细扫查,观察患者一般临床表现,分析超声图像特点分型、不同声像类型颗粒细胞瘤大小和血流分布情况,分析患者病理结果。结果38例卵巢颗粒细胞瘤患者均为单侧发病,形态规则,边界清,平均肿块最大径范围(8.8±3.8)cm。16例合并子宫内膜增厚,4例合并子宫内膜息肉,10例有腹水。声像图类型实性6例,平均径线(5.0±2.0)cm,肿块内血流信号分级:0级1例,2级2例,3级3例,平均血流阻力指数(0.49±0.05);声像图类型为囊实混合性30例,平均径线(8.8±3.2)cm,19例表现为多发小囊散在分布于实性成分内,呈“蜂窝”征改变,肿块内血流信号分级:0级4例,1级3例,2级13例,3级10例,平均血流阻力指数(0.42±0.08);声像图类型为囊性2例,平均径线(21.0±1.3)cm,肿块内血流信号分级:0级1例,1级1例,平均血流阻力指数(0.53±0.03)。33例病理诊断为成年型卵巢颗粒细胞瘤,5例诊断为幼年型颗粒细胞瘤。18例合并子宫内膜增生,4例合并子宫内膜息肉,病理结果与术前超声发现大致符合。结论卵巢颗粒细胞瘤以囊实混合性最常见,具有一定的超声图像特征,肿块内含多发小囊散在分布于实性成分,呈“蜂窝”征改变,彩色多普勒显示病灶可见较丰富血流信号。超声有助于卵巢颗粒细胞瘤的术前诊断。

Comparative analysis of ultrasound imaging and pathology in ovarian granulose cell tumor

Objective To discuss the application value of ultrasound in the diagnosis of ovarian granulosa cell tumor(OGCT).Methods The clinical data of 38 patients with ovarian granulosa cell tumor confirmed by operation and pathology and with complete clinical data were analyzed retrospectively.The uterus and ovaries of the patients were carefully scanned in multiple sections to observe the general clinical manifestations of the patients,and the ultrasonic image characteristics,the size and blood flow distribution of different types of granulosa cell tumor,as well as the pathological results of the patients were analyzed.Results The 38 patients with ovarian granulosa cell tumors were unilateral,with regular morphology,clear borders,and the largest diameter range of the mass(8.8±3.8)cm.16 patients had endometrial thickening,4 patients had endometrial polyps,and 10 had ascites.The type of sonogram was solid in 6 cases,with a mean diameter of(5.0±2.0)cm.The grading of blood flow signal in the mass:grade 0 in 1 case,grade 2 in 2 cases,grade 3 in 3 cases,and the blood flow resistance index was(0.49±0.05).The type of sonogram was mixed cystic solids in 30 cases,with a mean diameter of(8.8±3.2)cm.19 cases showed multiple small capsules scattered in the solid components,showing a"honeycomb"sign change,and the blood flow signal graded in the mass:grade 0 in 4 cases,grade 1 in 3 cases,grade 2 in 13 cases,grade 3 in 10 cases,and mean blood flow resistance index was(0.42±0.08).The type of sonogram was cystic in 2 cases,with a mean diameter line of(21.0±1.3)cm.The grading of blood flow signal in the mass:grade 0 in 1 case,grade 1 in 1 case,and the mean blood flow resistance index was(0.53±0.03).33 cases were diagnosed as adult granulosa cell tumor and 5 cases as juvenile granulosa cell tumor.There were 18 cases with endometrial hyperplasia and 4 cases with endometrial polyps.The pathological results were in accordance with the preoperative ultrasound findings.Conclusion Ovarian granulosa cell tumors are most commonly mixed with cystic solids and have certain ultrasound image characteristics:multiple small cysts within the mass are scattered throughout the solid components,showing a"honeycomb"sign change;color Doppler shows that the lesion has richer blood flow signal.Ultrasound is helpful for preoperative diagnosis of granulosa cell tumor of the ovary.