ISSN 1004-4140
CN 11-3017/P
何欣, 王新莲, 王克杨, 等. 卵巢支持-间质细胞瘤的影像表现及临床特征[J]. CT理论与应用研究(中英文), 2024, 33(4): 511-518. DOI: 10.15953/j.ctta.2024.050.
引用本文: 何欣, 王新莲, 王克杨, 等. 卵巢支持-间质细胞瘤的影像表现及临床特征[J]. CT理论与应用研究(中英文), 2024, 33(4): 511-518. DOI: 10.15953/j.ctta.2024.050.
HE X, WANG X L, WANG K Y, et al. MRI and CT Manifestation and Clinical Features of Ovarian Sertoli-Leydig Cell Tumor[J]. CT Theory and Applications, 2024, 33(4): 511-518. DOI: 10.15953/j.ctta.2024.050. (in Chinese).
Citation: HE X, WANG X L, WANG K Y, et al. MRI and CT Manifestation and Clinical Features of Ovarian Sertoli-Leydig Cell Tumor[J]. CT Theory and Applications, 2024, 33(4): 511-518. DOI: 10.15953/j.ctta.2024.050. (in Chinese).

卵巢支持-间质细胞瘤的影像表现及临床特征

MRI and CT Manifestation and Clinical Features of Ovarian Sertoli-Leydig Cell Tumor

  • 摘要: 目的:总结卵巢支持-间质细胞瘤(SLCT)的影像表现及临床特征,提高对本病的认识。方法:回顾性分析本院经手术及病理证实的15例SLCT患者的临床及影像学资料,其中15例均行MR扫描,5例同时行CT扫描。术前均行卵巢肿瘤标记物检测,10例行内分泌激素水平检测。结果:15例均为单侧单发病变,左侧8例,右侧7例,其中实性4例,囊实性11例。MRI表现:平扫实性成分呈等T1稍长T2信号为主,DWI高信号,ADC图信号减低,囊性成分呈长T1长T2信号;增强扫描4例实性肿瘤明显强化,11例囊实性中5例实性成分呈结节样、不规则分隔样或囊壁样明显强化,另6例呈混合强化,其中1例病理为中分化,余5例为中低及低分化。CT表现:实性部分呈软组织密度,液性部分呈水样密度。3例实性肿瘤增强扫描明显强化,2例囊实性肿瘤中1例实性成分明显强化,1例混合强化。激素水平检测结果9例睾酮升高,肿瘤标记物检测结果3例AFP水平升高,3例CA125升高,1例CA199升高。10例患者表现为雄激素刺激相关表现,2例雌激素刺激相关表现,2例为雌雄激素共同作用表现,1例无症状。病理结果2例为高分化SLCT,7例中分化,5例中低分化,1例低分化。结论:卵巢SLCT具有一定的影像及临床特征,呈实性或囊实性肿块,增强扫描实性成分呈明显强化或混合强化,中低或低分化者多呈混合强化;常伴有激素刺激相关表现,以雄激素刺激相关表现多见。

     

    Abstract: Objective: To summarize the imaging and clinical features of ovarian Sertoli–Leydig cell tumors (SLCT) to improve our understanding of the disease. Methods: The clinical and imaging data of 15 patients with SLCT confirmed by surgery and pathology were analyzed retrospectively. All patients underwent contrast-enhanced MRI, and five patients underwent contrast-enhanced CT. The expression levels of tumor markers and endocrine hormones were detected in 15 and 10 patients, respectively. Results: All 15 cases of SLCT were unilateral: 8 tumors in the left accessory and 7 tumors in the right accessory, and 4 solid tumors and 11 cystic solid tumors. MRI findings showed that solid components in masses were mainly indicated by intermediate intensity on T1WI and slight hyperintensity on T2WI, while cystic components were indicated by hypo-signal on T1WI and hyper-signal on T2WI. Solid components showed hyper-signals on DWI and hypo-signals on the ADC map. Four cases of solid tumors showed marked enhancement; all the solid components in five cases of cystic solid tumors showed marked enhancement, presenting as nodular, irregular septa, or cystic wall; and the other six cases of cystic solids showed mixed enhancement after administration of contrast medium. Among the six cases of mixed enhancement, five were moderately to poorly differentiated, and one was moderately differentiated. CT findings revealed that the solid components had soft tissue density, whereas cystic components had watery density. Three cases of solid tumors showed marked enhancement, while two cases of cystic solid tumors showed marked enhancement of the solid components or mixed enhancement. Nine patients had increased testosterone levels . Three patients had elevated AFP levels, two had elevated CA125 levels, and one had raised CA199 levels. Ten patients presented with androgen stimulation-related symptoms, two with estrogen stimulation-related symptoms, two with the co-action of estrogen and androgen and one without symptoms. Histopathological results showed that two cases were highly differentiated, seven were moderately differentiated, five were moderately to poorly differentiated, and one was poorly differentiated. Conclusion: SLCT presents as a solid or cystic solid mass, and solid components show either marked or mixed enhancement. Patients with moderate-to-poor and poor differentiation may present with mixed enhancement. SLCT often presents with symptoms related to stimulation of hormones, most commonly androgen.

     

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