Radiology Department, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, No.77 Zhenbi Road, Pingshan District, Shenzhen, 518020, Guangdong, China.
Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, Guangdong, China.
BMC Womens Health. 2022 Sep 1;22(1):362. doi: 10.1186/s12905-022-01949-x.
This study was designed to evaluate the specific imaging features of ovarian sclerosing stromal tumor (SST), improve its accuracy as well as the specificity of imaging diagnosing, and prevent overestimation of malignancy to reduce unnecessary surgical procedures.
Eight patients with magnetic resonance imaging (MRI) and six with computed tomography (CT) images were analyzed in this retrospective observational study. All the cases were confirmed by postoperative pathological examination as those of ovarian SST. Imaging and pathological features were also evaluated.
All the 14 masses displayed cystic and solid components with outer surface of tumors contained a capsular and complete smooth rim. Eight tumors of MRI exhibited "lake-island" sign on T2 weighted imaging (T2WI). Two of the 6 CT cases displayed a flaky calcification. One case showed as a multiloculated cystic mass with irregularly thickened septae and the tumor wall. The solid components in other 13 masses were comb- or wheel-like enhanced. After injection of contrast agent, the solid components in 8 cases (57.1%) appeared as early enhancement, whereas the other 6 cases (42.9%) appeared as progressive enhanced, and the cystic components of all the cases had no enhancement in the whole course. Vascular flow signals or/and marked enhancement of the blood vessels were found in 12 lesions (85.7%). Pathological examination demonstrated pseudolobule patterns, round to spindle shaped cells, collagenous areas, edematous hypocellular areas and prominent vasculatures.
The results demonstrated that MRI with "lake-island" signs on T2WI and MRI/CT dynamic enhancement could potentially play a critical role in facilitating appropriate diagnosis preoperatively.
本研究旨在评估卵巢硬化性间质瘤（SST）的特定影像学特征，提高其影像学诊断的准确性和特异性，防止过度估计恶性程度，减少不必要的手术。
本回顾性观察性研究分析了 8 例磁共振成像（MRI）和 6 例计算机断层扫描（CT）图像患者。所有病例均经术后病理检查证实为卵巢 SST。评估了影像学和病理学特征。
所有 14 个肿块均显示囊实性成分，肿瘤外表面包含包膜和完整光滑的边缘。8 个 MRI 肿瘤在 T2 加权成像（T2WI）上显示“湖岛”征。6 例 CT 中有 2 例显示片状钙化。1 例表现为多房囊性肿块，间隔不规则增厚，肿瘤壁增厚。13 个肿块的实性成分呈梳状或轮状强化。增强后，8 例（57.1%）实性成分呈早期强化，6 例（42.9%）呈渐进性强化，所有病例的囊性成分在整个过程中均无强化。12 个病灶（85.7%）可见血管流信号或/和血管明显强化。病理检查显示假小叶模式、圆形至梭形细胞、胶原区、水肿性细胞稀少区和明显的脉管系统。
结果表明，T2WI 上的“湖岛”征和 MRI/CT 动态增强 MRI 可能对术前适当诊断起关键作用。
