Weng Wei, Chen Yaomeng, Liu Ze, Chen Weiqian, Hu Jiejie, Chen Huihui, Pan Xindian, Wu Hai, Chi Xinle
Department of Radiology, The Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, Zhejiang, 325000, China.
Department of Radiology, Ningbo Ninth Hospital, Ningbo, Zhejiang, 315000, China.
BMC Med Imaging. 2024 Dec 30;24(1):354. doi: 10.1186/s12880-024-01529-5.
This study investigates the MRI characteristics of primary and metastatic adult granulosa cell tumor with normal estrogen levels (AGCT-NEL) to enhance clinical understanding and diagnostic accuracy of this disease.
We collected clinical data from 10 patients with AGCT-NEL, confirmed by pathology, treated at our hospital from January 2016 to January 2024. We retrospectively analyzed the MRI features of primary and metastatic lesions from aspects such as shape, edge characteristics, MRI signal, and enhancement features.
A total of 10 AGCT-NEL patients were included in this study, aged 28 to 81 years, with an average age of 54 ± 16 years. The primary tumors primarily presented as unilocular cystic, solid, and cystic-solid types. The solid components showed isointense to slightly hypointense signals on T1-weighted imaging (TWI), slightly hyperintense signals on T2-weighted imaging (TWI), and high signals on diffusion-weighted imaging (DWI), with possible internal hemorrhage or cystic degeneration. The cystic components exhibited low signal on TWI, high signal on TWI, uniform wall thickness, and no wall nodules, typically showing hemorrhagic fluid levels. Honeycomb and Swiss cheese signs are sometimes observed in cystic-solid tumors. All metastatic lesions were cystic (either unilocular or multilocular), presenting low signal on TWI and high signal on TWI, with no wall nodules and possible internal hemorrhagic fluid levels. The multilocular metastatic tumors demonstrated unevenly thickened partitions, also displaying honeycomb and Swiss cheese signs.
The MRI characteristics of primary and metastatic lesions in AGCT-NEL possess specific features, such as signs of hemorrhage, absence of wall nodules in the cystic portions of the tumors, and distinctive honeycomb and Swiss cheese signs, with metastatic lesions being cystic. Understanding these features can aid in improving preoperative diagnostic capabilities and reducing misdiagnosis.
本研究探讨雌激素水平正常的成人颗粒细胞瘤（AGCT-NEL）的原发性和转移性肿瘤的MRI特征，以提高对该疾病的临床认识和诊断准确性。
收集2016年1月至2024年1月在我院接受治疗且经病理证实的10例AGCT-NEL患者的临床资料。我们从形态、边缘特征、MRI信号和强化特征等方面回顾性分析原发性和转移性病变的MRI特征。
本研究共纳入10例AGCT-NEL患者，年龄28至81岁，平均年龄54±16岁。原发性肿瘤主要表现为单房囊性、实性及囊实性类型。实性成分在T1加权成像（TWI）上呈等信号至稍低信号，在T2加权成像（TWI）上呈稍高信号，在扩散加权成像（DWI）上呈高信号，可能存在内部出血或囊性变。囊性成分在TWI上呈低信号，在TWI上呈高信号，壁厚度均匀，无壁结节，典型表现为出血液平面。囊实性肿瘤有时可见蜂窝状和瑞士奶酪征。所有转移性病变均为囊性（单房或多房），在TWI上呈低信号，在TWI上呈高信号，无壁结节，可能存在内部出血液平面。多房转移性肿瘤显示分隔不均匀增厚，也表现出蜂窝状和瑞士奶酪征。
AGCT-NEL原发性和转移性病变的MRI特征具有特异性，如出血征象、肿瘤囊性部分无壁结节以及独特的蜂窝状和瑞士奶酪征，转移性病变为囊性。了解这些特征有助于提高术前诊断能力并减少误诊。
