黄斌 刘祎 陈永露 陈文俊 宋亭

[摘要] 目的 探讨卵巢性索间质肿瘤MRI特征和临床病理的相关性。 方法 回顾性分析广州医科大学附属第三医院2012年7月～2017年6月经手术病理证实的30例卵巢性索间质肿瘤患者的MRI特征，观察肿瘤大小、形态、信号、强化方式、子宫改变、盆腔积液等，及其临床病理结构特征。 结果 本研究30例卵巢性索间质肿瘤中，纤维-卵泡膜组肿瘤22例，占73.33%，其中纤维瘤3例，卵泡膜细胞瘤8例，纤维卵泡膜细胞瘤11例，T1WI为等或低信号、T2WI为等或高信号，含纤维成分较多时肿块T1WI和T2WI呈低信号为主，增强后，轻度强化18例，中度强化4例；颗粒细胞瘤8例，占26.67%，T1WI为等或低信号、T2WI为高信号，增强扫描可见肿块囊壁及分隔明显强化。 结论 MRI对卵巢性索间质肿瘤的诊断具有重要价值，MRI表现与其临床病理结构特征密切相关。

[关键词] 卵巢；性索间质肿瘤；病理；核磁共振

[中图分类号] R737.31 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0135-04

[Abstract] Objective To investigate the value of magnetic resonance imaging （MRI） diagnosis for ovarian sex cord-stromal tumor， and the correlation of its MRI findings with pathological features. Methods The MRI findings of 30 patients of ovarian sex cord-stromal tumor confirmed by pathological features were retrospectively analyzed in the Third Affiliated Hospital of Guangzhou Medical University from 2012 July to 2017 June. The correlation of imaging features with clinical pathological structural features was analyzed. Results Among the 30 patients of ovarian sex cord-stromal tumor， 22 （73.33%） were thecoma-fibroma folliculi tumor， including 3 patients of fibroma， 8 patients of theca cell tumor， 11 patients of thec-fibroma. The lesions were isointesity or hypointense on T1WI and equal or higher signal on T2WI. Fiber components showed lower signal on T1WI and T2WI， with slight enhancement in 18 cases and moderate enhancement in 3 cases after contrast medium injection. There were 8 （26.67%） cases of granulosa-cell tumors. The lesions were isointesity or hypointense on T1WI and higher signal on T2WI. Cystic walls and septation showed obvious enhancement on contrast-enhanced images. Conclusion MRI has some characteristics to assess and diagnosis ovarian sex cord-stromal tumor， and MRI features of each type of tumor have a certain internal correlation with clinical pathological structural features.

[Key words] Ovary； Sex cord-stromal tumor； Pathology； Magnetic resonance imaging

卵巢性索間质肿瘤（ovarian sex cord-stromal tumor，OSCST）来源于原始性腺中的性索及间质组织，由不同分化程度的性索样细胞、性腺间质成分及其各种黄素化细胞单一或混合构成。OSCST占全部卵巢病变的2%～5%、卵巢肿瘤的8%，治疗上以手术切除为主[1]。由于OSCST发病率相对较低，加上认识不足，术前常不能确诊[2-5]。本研究回顾了经手术病理证实的30例卵巢性索间质肿瘤的MRI表现和临床病理资料，探讨OSCST的MRI特征，结合其临床和病理学表现，以期提高OSCST的术前准确诊断率。

1 资料与方法

1.1 一般资料

回顾性分析2012年7月～2017年6月于广州医科大学附属第三医院经手术病理证实的卵巢性索间质肿瘤30例，年龄35～74岁，中位年龄52岁，纤维-卵泡膜组肿瘤22例（73.33%）：纤维瘤3例，卵泡膜纤维瘤11例，卵泡膜细胞瘤8例。……