卵巢卵泡膜细胞瘤超声特征与鉴别诊断.docVIP

卵巢卵泡膜细胞瘤超声特征与鉴别诊断 　　中图分类号:R445.1 　　文献标识码: A 　　文章编号: 1672-3783(2010)-03-0040-02 　　【摘 要】目的 探讨卵巢卵泡膜细胞瘤的超声特征及重要鉴别诊断。方法 21例患者术前行彩超检查,术后将手术、化验检查及病理结果与超声表现行对照分析。结果 20 例肿瘤均呈实性;其中17例 5cm, 15例内部回声为均匀低回声,6例内部回声不均匀,其中3例内见少许无回声号,4例内部或周边见少许血流,余均未见明显血流。其中1例漏诊,2例误诊为肌瘤。女性化作用明显14例,占62.5%。结论 卵巢卵泡膜细胞瘤根据超声表现的规律性,结合临床女性化作用可与其他卵巢实性肿瘤作出鉴别。 　　【关键词】卵巢 卵泡膜细胞瘤 超声 　　Ultrasonic Characteristics and Differential Diagnosis 　　NIU Ming-chang 　　The Traditional Chinese Medicine Hospital of Dongyin Hekou,Hekou 257234,China 　　【Abstract】Objective TO study the ultrasonic character of ovarian thecoma and differential diagnosis.Methods we reviewed operation data,chemical examination and pathologic findings of 21 cases of ovarian thecoma retrospectively and analyzed them by contracted with color Doppler ultrasonography.Results All of 21cases were soild mass,among them 17 cases were more than 5cm in diameter and 15 cases were even low echo,other 6 cases were uneven echo,echo-free were found in 3 cases and 5 cases were found less blood flow signal in the center or in the rim,Other showed no signs of obvious blood flow signal.One cases was misdiagnosed and 2 cases were missed diagnosis for myoma.14 cases were obviously feminization effect account for 62.5%.Conclusions ovarian thecoma could differentiate for ovarian soild tumors according to ultrasonography characters and clinical character of feminization feeect. 　　【Kye words】Thecoma;Ovarian the coma ;lteasonography 　　 　　卵巢卵泡膜细胞瘤起源于卵巢的特殊胚叶组织,由卵泡膜细胞构成,是卵泡性索质肿瘤中的一种,为具有内分泌功能的实性肿瘤。卵巢实性肿瘤种类较多,诊断较困难。本研究回顾分析16例卵巢卵泡膜细胞瘤患者的彩色多普勒超声结果、手术及病理资料,根据肿瘤超声检查的规律性特征,结合临床,提出超声诊断及鉴别诊断。 　　1 临床资料 　　1.1 研究对象 　　2000年1月至2008年12月经手术及病理证实为卵巢卵泡膜细胞瘤21例。年龄45~46岁,平均55岁,均为经产妇,其中绝经后患者15例,育龄妇女6例,14例以盆腔包块,2例已绝经后出血,5例以下腹部疼痛不适为首发症状。 　　1.2 研究方法 采用GE500、GE500pro、Acuson128xp-10、Powervison8000彩色多普勒超声诊断仪,探头频率4.0MHz,患者仰卧位,膀脱适当充盈后经腹检查,依次观察子宫、包块及双附件区的二维超声表现及彩色多普勒表现,选典型声像图留档。 　　2 结果 　　21例肿瘤大小不一,最小直径约2cm,最大直径约13cm,其中17例最大径 5cm,肿瘤呈圆形或类圆形14例,呈不规则分叶状6例。超声表现均为边界清晰,后方回声轻度增强的低回声实性团块,15例内部回声均匀,6例内部回