Jung Seung Eun, Lee Jae Mun, Rha Sung Eun, Byun Jae Young, Jung Jung Im, Hahn Seong Tai
Department of Radiology, St Mary's Hospital, Catholic University of Korea, 62 Yeouido-dong, Youngdungpo-gu, Seoul 150-713, Korea.
Radiographics. 2002 Nov-Dec;22(6):1305-25. doi: 10.1148/rg.226025033.
Ovarian tumors are classified on the basis of tumor origin as epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, embryonal carcinoma), sex cord-stromal tumors (fibrothecoma; granulosa cell, sclerosing stromal, and Sertoli-Leydig cell tumors), and metastatic tumors. Epithelial tumors are primarily cystic and, when malignant, are associated with varying proportions of a solid component. Papillary projections are a distinctive feature of epithelial tumors. Profuse papillary projections are highly suggestive of borderline (low-malignant-potential) or malignant tumor. Ovarian teratomas demonstrate lipid material at computed tomography and magnetic resonance (MR) imaging. Malignant germ cell tumors manifest as a large, complex abdominal mass that contains both solid and cystic components. Tumor markers are helpful in diagnosis. The radiologic appearance of sex cord-stromal tumors varies from small solid masses to large multicystic masses. Granulosa cell tumors are usually large multicystic masses with solid components. Fibrothecoma, sclerosing stromal tumor, and Sertoli-Leydig cell tumors are usually solid masses. Fibromas have very low signal intensity on T2-weighted MR images. Certain radiologic findings predominate for each type of tumor. Knowledge of these key features of ovarian tumors provides the criteria for making a specific diagnosis or substantially narrowing the differential diagnosis.
卵巢肿瘤根据肿瘤起源可分为上皮性肿瘤（浆液性和黏液性肿瘤、子宫内膜样癌和透明细胞癌、勃勒纳瘤）、生殖细胞肿瘤（成熟和未成熟畸胎瘤、无性细胞瘤、内胚窦瘤、胚胎性癌）、性索间质肿瘤（纤维卵泡膜瘤；颗粒细胞瘤、硬化性间质瘤和支持-间质细胞瘤）以及转移性肿瘤。上皮性肿瘤主要为囊性，恶变时伴有不同比例的实性成分。乳头样突起是上皮性肿瘤的一个显著特征。大量乳头样突起高度提示交界性（低恶性潜能）或恶性肿瘤。卵巢畸胎瘤在计算机断层扫描和磁共振成像上表现为脂质物质。恶性生殖细胞肿瘤表现为巨大、复杂的腹部肿块，包含实性和囊性成分。肿瘤标志物有助于诊断。性索间质肿瘤的影像学表现从小的实性肿块到巨大的多囊性肿块不等。颗粒细胞瘤通常是带有实性成分的巨大多囊性肿块。纤维卵泡膜瘤、硬化性间质瘤和支持-间质细胞瘤通常为实性肿块。纤维瘤在T2加权磁共振图像上信号强度很低。每种类型的肿瘤都有某些主要的影像学表现。了解卵巢肿瘤的这些关键特征为做出特定诊断或显著缩小鉴别诊断范围提供了标准。
