1 Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
Br J Radiol. 2014 Jun;87(1038):20130634. doi: 10.1259/bjr.20130634. Epub 2014 Mar 27.
To study MRI diagnosis of ovarian fibrothecomas.
MRI appearances of 27 ovarian fibrothecomas 26 female patients confirmed by surgical pathology were retrospectively reviewed and correlated with clinical and histological findings.
Most patients were post-menopausal females 73.1% (19/26) of cases. 38.5% (10/26) of patients showed an elevated serum carbohydrate antigen 125 (CA-125) level (>35 U ml(-1)). On MR T2 weighted imaging, 3 distinct features were revealed. (1) Homogeneous hypointense masses in 25.9% (7/27) cases. (2) Heterogeneous tumours with mostly isointense and few patchy hyperintense areas in 51.9% (14/27) cases. (3) Heterogeneous tumours with predominantly hyperintense and few isointense parts in 22.2% (6/27) cases. On T1 weighted imaging, all the fibrothecomas turned out to be homogeneous masses except six cystic degeneration cases. After contrast, 70.4% (19/27) tumours showed homogeneous mild enhancement in all phases. Beyond the tumours, endometrial abnormality and uterus enlargement were found in 38.5% (10/26) and 15.4% (4/26) patients, respectively. Ascites were seen in 53.8% (14/26) patients. There was a statistically significant difference among the 3 T2 weighted image features (F = 7.024; p = 0.003) in terms of the size of fibrothecomas. The cystic tumours also had the tendency to show the ascite condition (p = 0.002) as well as elevated serum CA-125 levels (p = 0.014). Vimentin was positively stained in 10 (76.9%) of 13 cases who underwent the immunohistochemical analysis.
MRI has the superiority to show the distinct appearances of tumours as well as their functional features according to oestrogenic effect.
This study describes the unique features of fibrothecomas on MRI on a relatively large series of patients with tumours and the indirect oestrogenic effect findings.
研究卵巢纤维卵泡膜细胞瘤的 MRI 诊断。
回顾性分析 26 例经手术病理证实的卵巢纤维卵泡膜细胞瘤患者的 27 例 MRI 表现，并与临床和组织学发现进行相关性分析。
大多数患者为绝经后女性（73.1%，19/26）。38.5%（10/26）的患者血清糖链抗原 125（CA-125）水平升高（>35 U/ml）。在 MR T2 加权成像上，显示出 3 种不同的特征。（1）25.9%（7/27）的病例为均匀低信号肿块。（2）51.9%（14/27）的病例为不均匀肿瘤，多数为等信号，少数为斑片状高信号区。（3）22.2%（6/27）的病例为不均匀肿瘤，以高信号为主，少数为等信号。在 T1 加权成像上，除 6 例囊性变性外，所有纤维卵泡膜细胞瘤均为均匀肿块。增强后，70.4%（19/27）的肿瘤在各期均呈均匀轻度强化。除肿瘤外，38.5%（10/26）和 15.4%（4/26）的患者分别发现子宫内膜异常和子宫增大，53.8%（14/26）的患者出现腹水。3 种 T2 加权图像特征（F = 7.024，p = 0.003）在纤维卵泡膜细胞瘤的大小方面存在统计学差异。囊性肿瘤也有出现腹水（p = 0.002）和血清 CA-125 水平升高（p = 0.014）的趋势。13 例接受免疫组织化学分析的患者中，10 例（76.9%）Vimentin 阳性染色。
MRI 具有显示肿瘤的独特表现及其根据雌激素效应的功能特征的优势。
本研究描述了在相对较大的肿瘤患者系列中纤维卵泡膜细胞瘤的 MRI 特征以及间接的雌激素效应发现。
