Chen Jingya, Wang Jianhua, Chen Xiao, Wang Yaohui, Wang Zhongqiu, Li Dake
Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China.
Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, P.R. China.
Oncol Lett. 2017 Jul;14(1):1172-1178. doi: 10.3892/ol.2017.6228. Epub 2017 May 22.
The aim of the present study was to investigate the imaging characteristics of ovarian fibrothecoma. The cases of 25 female patients with pathologically confirmed ovarian fibrothecomas were retrospectively reviewed. Tumor location, size, density, signal intensity, cystic degeneration, calcification, enhancement pattern and ascites were assessed by computed tomography (CT) (n=20) and magnetic resonance imaging (MRI) (n=5). Clinical and histological features were also evaluated. The results revealed that 23 (92.0%) patients were postmenopausal, with a mean age ± standard deviation (SD) of 60.7±10.8 years old. All 25 tumors were unilateral and a thickened endometrium was observed in 7 (28.0%) patients. In total, 24 (96.0%) tumors appeared to have well-defined boundaries, with 1 (4%) tumor exhibiting an obscure boundary. Tumors had a mean size of 9.8±5.3 cm. Solid and predominantly solid masses were found in 16 cases (64.0%), and cystic and predominantly cystic masses were found in 9 patients (36.0%). Solid regions of masses exhibited hypodensity or isodensity in 24 patients (96.0%), with 1 patient (4.0%) exhibiting hyperdensity. The mean CT value (± SD) was 44.2±12.8 HU (range, 31-79HU) in unenhanced images. All masses exhibited isointensity or slight hypointensity on T1-weighted imaging, and tumor parenchyma also exhibited slight hypointensity or isointensity on T2-weighted imaging compared with the myometrium, with or without areas of patchy hyperintensity. Contrast-enhanced CT or MRI scans were performed on 19 patients, and the solid components (94.7%) exhibited mild to moderate enhancement in 18 patients and 1 patient (5.3%) exhibited intense enhancement. Tumor size was positively correlated with the tumor cystic degeneration (r=0.77, P<0.001) and ascites (r=0.41, P<0.001). Therefore, ovarian fibrothecoma typically presents as solid or predominant solid masses with clear boundaries; the parenchyma of the tumor exhibits isodensity on CT scans, slight hypointensity or isointensity on MRI and mild enhancement following contrast-medium injection. The thickened endometrium observed in postmenopausal woman may also be a valuable imaging feature.
本研究的目的是探讨卵巢纤维瘤的影像学特征。对25例经病理证实为卵巢纤维瘤的女性患者病例进行回顾性分析。通过计算机断层扫描（CT）（n = 20）和磁共振成像（MRI）（n = 5）评估肿瘤的位置、大小、密度、信号强度、囊性变、钙化、强化方式及腹水情况。同时评估临床和组织学特征。结果显示，23例（92.0%）患者为绝经后女性，平均年龄±标准差（SD）为60.7±10.8岁。25个肿瘤均为单侧，7例（28.0%）患者观察到子宫内膜增厚。24个（96.0%）肿瘤边界清晰，1个（4%）肿瘤边界不清。肿瘤平均大小为9.8±5.3 cm。16例（64.0%）为实性及以实性为主的肿块，9例（36.0%）为囊性及以囊性为主的肿块。24例（96.0%）肿块实性区域呈低密度或等密度，1例（4.0%）呈高密度。平扫图像上平均CT值（±SD）为44.2±12.8 HU（范围31 - 79 HU）。所有肿块在T1加权成像上呈等信号或轻度低信号，与子宫肌层相比，肿瘤实质在T2加权成像上也呈轻度低信号或等信号，伴有或不伴有斑片状高信号区。19例患者进行了CT或MRI增强扫描，18例患者（94.7%）实性成分呈轻度至中度强化，1例患者（5.3%）呈明显强化。肿瘤大小与肿瘤囊性变（r = 0.77，P < 0.001）及腹水（r = 0.41，P < 0.001）呈正相关。因此，卵巢纤维瘤通常表现为边界清晰的实性或以实性为主的肿块；肿瘤实质在CT扫描上呈等密度，在MRI上呈轻度低信号或等信号，注射造影剂后呈轻度强化。绝经后女性观察到的子宫内膜增厚也可能是一个有价值的影像学特征。
