Jiang Yuemingming, Ding Yanhua, Guo Minhua, Yu Yue, Duan Hongpeng, Zhang Shengmin
Department of Ultrasonography, The First Affiliated Hospital of Ningbo University, 51#, Liuting Road, Ningbo, Zhejiang, 315010, China.
Department of Ultrasonography, Hangzhou Women's Hospital, Hangzhou, Zhejiang, China.
BMC Med Imaging. 2025 May 20;25(1):175. doi: 10.1186/s12880-025-01693-2.
Ovarian thecoma-fibroma group (OTFG) is an unusual type of ovarian cancer with three histopathologic subtypes, but their features on ultrasonography are still poorly understood. This study evaluated the features of different histopathological subtypes of OTFG on conventional ultrasonography and contrast-enhanced ultrasonography (CEUS).
This retrospective study enrolled sixty-nine women with pathologically confirmed OTFG who underwent preoperative CEUS. The characteristics of OTFG on conventional ultrasonography and CEUS, clinical manifestations, and laboratory findings were compared among subtypes.
Fourteen patients were diagnosed with fibroma, fifty-one with thecofibroma, and four with thecoma. Although 69% of patients were post-menopausal, thecoma patients were significantly younger than those in other two groups. Laboratory examination revealed 21.7% (15/69) of patients had high carbohydrate antigen 125 (CA-125) level. On conventional ultrasonography, 72.5% (50/69) masses showed solid type, 24.6% (17/69) showed mixed cystic-solid type, and only 2.9% (2/69) showed cystic type. On CEUS, 50% (2/4) of thecoma lesions were rapid enhancement, 58.8% (30/51) of thecofibroma lesions and 78.6% (11/14) of fibroma lesions showed slow enhancement, 75% (3/4) of thecoma lesions showed isoenhancement during the descent process, and only 13.75% (7/51) of thecofibroma lesions and 7.1% (1/14) of fibroma lesions showed isoenhancement during the descent. they varied significantly among different histopathological subtypes.
The majority of OTFG is solid-like on conventional ultrasonography. Menopause is an important factor related to the subtype of OTFG. In postmenopausal patients with solid adnexal masses, slow hypoenhancement on CEUS is an important feature of fibroma. In premenopausal patients with solid or mixed cystic-solid adnexal masses, thecoma may be considered when rapid hyperenhancement, and isoenhancement or hypoenhancement during descent are observed on CEUS.
Not applicable.
卵巢纤维瘤-卵泡膜细胞瘤组（OTFG）是一种不常见的卵巢癌类型，有三种组织病理学亚型，但其超声特征仍了解不足。本研究评估了OTFG不同组织病理学亚型在传统超声和超声造影（CEUS）上的特征。
本回顾性研究纳入了69例经病理证实为OTFG且术前行CEUS检查的女性患者。比较了各亚型OTFG在传统超声和CEUS上的特征、临床表现及实验室检查结果。
14例患者诊断为纤维瘤，51例为纤维卵泡膜瘤，4例为卵泡膜瘤。尽管69%的患者已绝经，但卵泡膜瘤患者明显比其他两组患者年轻。实验室检查显示21.7%（15/69）的患者糖类抗原125（CA-125）水平升高。在传统超声上，72.5%（50/69）的肿块为实性，24.6%（17/69）为囊实性混合，仅2.9%（2/69）为囊性。在CEUS上，50%（2/4）的卵泡膜瘤病变呈快速增强，58.8%（30/51）的纤维卵泡膜瘤病变和78.6%（11/14）的纤维瘤病变呈缓慢增强，75%（3/4）的卵泡膜瘤病变在消退过程中呈等增强，而仅13.75%（7/51）的纤维卵泡膜瘤病变和7.1%（1/14）的纤维瘤病变在消退过程中呈等增强。不同组织病理学亚型之间差异显著。
大多数OTFG在传统超声上呈类实性。绝经是与OTFG亚型相关的重要因素。在绝经后附件实性肿块患者中，CEUS上缓慢低增强是纤维瘤的重要特征。在绝经前附件实性或囊实性混合肿块患者中，当CEUS显示快速高增强、消退过程中等增强或低增强时，可能考虑卵泡膜瘤。
不适用。
