妇科疾病影像学（十六）：附件浆液性囊腺瘤纤维瘤的临床及超声特征。

Imaging in gynecological disease (16): clinical and ultrasound characteristics of serous cystadenofibromas in adnexa.

机构信息

Istituto di Ginecologia ed Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy.

Department of Obstetrics and Gynecology, Policlinico Hospital, Abano Terme, Padua, Italy.

出版信息

Ultrasound Obstet Gynecol. 2019 Dec;54(6):823-830. doi: 10.1002/uog.20277.

DOI:10.1002/uog.20277

PMID:30937992

Abstract

OBJECTIVE

To describe the clinical and ultrasound characteristics of serous cystadenofibromas in the adnexa.

METHODS

This was a retrospective study of patients identified in the International Ovarian Tumor Analysis (IOTA) database, who had a histological diagnosis of serous cystadenofibroma and had undergone preoperative ultrasound examination by an experienced ultrasound examiner, between 1999 and 2012. In the IOTA database, which contains data collected prospectively, the tumors were described using the terms and definitions of the IOTA group. In addition, three authors reviewed, first independently and then together, ultrasound images of serous cystadenofibromas and described them using pattern recognition.

RESULTS

We identified 233 women with a histological diagnosis of serous cystadenofibroma. In the IOTA database, most cystadenofibromas (67.4%; 157/233) were described as containing solid components but 19.3% (45/233) were described as multilocular cysts and 13.3% (31/233) as unilocular cysts. Papillary projections were described in 52.4% (122/233) of the cystadenofibromas. In 79.5% (97/122) of the cysts with papillary projections, color Doppler signals were absent in the papillary projections. Most cystadenofibromas (83.7%; 195/233) manifested no or minimal color Doppler signals. On retrospective analysis of 201 ultrasound images of serous cystadenofibromas, using pattern recognition, 10 major types of ultrasound appearance were identified. The most common pattern was a unilocular solid cyst with one or more papillary projections, but no other solid components (25.9%; 52/201). The second most common pattern was a multilocular solid mass with small solid component(s), but no papillary projections (19.4%; 39/201). The third and fourth most common patterns were multi- or bilocular cyst (16.9%; 34/201) and unilocular cyst (11.9%; 24/201). Using pattern recognition, shadowing was identified in 39.8% (80/201) of the tumors, and microcystic appearance of the papillary projections was observed in 34 (38.6%) of the 88 tumors containing papillary projections.

CONCLUSIONS

The ultrasound features of serous cystadenofibromas vary. The most common pattern is a unilocular solid cyst with one or more papillary projections but no other solid components, with absent color Doppler signals. Most serous cystadenofibromas were poorly vascularized on color Doppler examination and many manifested acoustic shadowing. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

摘要

目的

描述附件浆液性囊腺瘤的临床和超声特征。

方法

这是一项回顾性研究，研究对象为国际卵巢肿瘤分析（IOTA）数据库中 1999 年至 2012 年间经经验丰富的超声检查人员进行术前超声检查并经组织学诊断为浆液性囊腺瘤纤维瘤的患者。在 IOTA 数据库中，该数据库包含前瞻性收集的数据，使用 IOTA 组的术语和定义描述肿瘤。此外，三位作者首先独立地、然后共同地回顾了浆液性囊腺瘤纤维瘤的超声图像，并使用模式识别对其进行了描述。

结果

我们确定了 233 名组织学诊断为浆液性囊腺瘤纤维瘤的女性患者。在 IOTA 数据库中，大多数囊腺瘤纤维瘤（67.4%；157/233）被描述为含有实性成分，但 19.3%（45/233）被描述为多房性囊肿，13.3%（31/233）为单房性囊肿。在 233 例囊腺瘤纤维瘤中，52.4%（122/233）有乳头状突起。在 79.5%（97/122）有乳头状突起的囊中，彩色多普勒信号在乳头状突起中不存在。大多数囊腺瘤纤维瘤（83.7%；195/233）表现为无或极少的彩色多普勒信号。使用模式识别对 201 例浆液性囊腺瘤纤维瘤的超声图像进行回顾性分析，确定了 10 种主要的超声表现类型。最常见的类型是有一个或多个乳头状突起的单房性实性囊肿，但没有其他实性成分（25.9%；52/201）。第二种最常见的类型是多房性实性肿块，伴有小的实性成分，但没有乳头状突起（19.4%；39/201）。第三种和第四种最常见的类型是多房或双房性囊肿（16.9%；34/201）和单房性囊肿（11.9%；24/201）。使用模式识别，在 39.8%（80/201）的肿瘤中发现了阴影，在 88 个含有乳头状突起的肿瘤中，有 38.6%（34 个）观察到乳头状突起的微囊性外观。