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卵巢纤维瘤的 CT 复查。

CT review of ovarian fibrothecoma.

机构信息

Mid South Essex NHS Foundation Trust, England, United Kingdom.

BronxCare Health System, New York City, United States.

出版信息

Br J Radiol. 2022 Aug 1;95(1136):20210790. doi: 10.1259/bjr.20210790. Epub 2022 Jul 12.

DOI:10.1259/bjr.20210790
PMID:35451310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10162058/
Abstract

OBJECTIVE

The aim of this study was to investigate the CT imaging characteristics of ovarian fibrothecoma which may aid in the differentiation from early stage epithelial tumours.

METHODS

Comparison of 36 patients (41 lesions) with pathologically proven ovarian fibrothecoma tumours and 36 (52 lesions) serous papillary carcinomas (SPCs) lesions. We noted their laterality, size, density, calcifications, Hounsfield units (HUs) and introduced a novel HU comparison technique with the psoas muscle or the uterus. Patients' clinical findings such as ascites, pleural effusion, carbohydrate antigen-125 levels, and lymphadenopathy findings were also included.

RESULTS

Average age was 67.8 and 66 across the fibrothecoma and SPC cohort respectively. Fibrothecoma tumours had diameters ranging from 24 to 207 mm (Median: 94 mm). 80.6% of the fibrothecoma cohort had ascites which was comparable to the 72.2% in the SPC cohort. 70.7% of fibrothecoma tumour favour a purely to predominantly solid structural configuration ( < 0.001). The average HU value for the fibrothecoma solid component was 44 ± 11.7 contrasting the SPC HU value of 66.8 ± 15. The psoas:tumour mass ratio demonstrated a median of 0.7, whereas SPCs shows a median of 1.1 ( < 0.001).

CONCLUSION

Suspicion of ovarian fibrothecoma should be considered through interrogation of their structural density configuration, low psoas to mass HU ratio and a presence of ascites.

ADVANCES IN KNOWLEDGE

CT imaging can be a useful tool in diagnosing fibrothecoma tumours and subsequently reducing oncogynaecological tertiary centre referrals, financial burden and patient operative morbidity and mortality.

摘要

目的

本研究旨在探讨卵巢纤维卵泡膜细胞瘤的 CT 影像学特征，以帮助其与早期上皮性肿瘤相鉴别。

方法

比较 36 例（41 个病灶）经病理证实的卵巢纤维卵泡膜细胞瘤患者和 36 例（52 个病灶）浆液性乳头状癌患者。我们记录了它们的侧别、大小、密度、钙化、Hounsfield 单位（HU），并引入了一种新的 HU 比较技术，即与腰大肌或子宫进行比较。还包括患者的临床发现，如腹水、胸腔积液、CA125 水平和淋巴结肿大。

结果

纤维卵泡膜细胞瘤组和浆液性乳头状癌组的平均年龄分别为 67.8 岁和 66 岁。纤维卵泡膜细胞瘤的肿瘤直径范围为 24 至 207mm（中位数：94mm）。80.6%的纤维卵泡膜细胞瘤组有腹水，与浆液性乳头状癌组的 72.2%相似。70.7%的纤维卵泡膜细胞瘤肿瘤倾向于单纯或主要为实性结构（<0.001）。纤维卵泡膜细胞瘤实性成分的平均 HU 值为 44±11.7，而浆液性乳头状癌的 HU 值为 66.8±15。腰大肌：肿瘤肿块比值中位数为 0.7，而浆液性乳头状癌则为 1.1（<0.001）。

结论

通过询问其结构密度特征、较低的腰大肌与肿瘤 HU 比值和腹水的存在，应怀疑为卵巢纤维卵泡膜细胞瘤。

知识进展

CT 成像可以作为诊断纤维卵泡膜细胞瘤的有用工具，从而减少妇科肿瘤三级转诊、经济负担以及患者手术发病率和死亡率。

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