卵巢恶性生殖细胞肿瘤的MRI诊断

目的:探讨卵巢恶性生殖细胞肿瘤的临床症状及MRI表现。方法:回顾性分析7例经手术病理证实的卵巢恶性生殖细胞肿瘤临床资料及MRI图像,其中无性细胞瘤1例、卵黄囊瘤3例、未成熟畸胎瘤2例和混合性生殖细胞肿瘤1例。结果:7例患者临床症状表现为腹痛1例,腹部肿块3例,腹胀3例。血清肿瘤标记物检查:AFP明显增高6例,CA125升高3例。MRI表现:7例均为单侧病灶,其中右侧4例,左侧3例。类圆形6例,分叶状1例,边界均清晰。最大径均大于9 cm。除无性细胞瘤为实性成分外,其他6例均为囊实性。无性细胞瘤内见低信号分隔,2例未成熟畸胎瘤见小囊样液性信号区,并可见散在脂肪信号。增强扫描:无性细胞瘤中等度强化,内见持续强化分隔;6例囊实性肿瘤实性部分不均匀持续强化,3例卵黄囊瘤可见"蜂窝征",2例未成熟畸胎瘤见多发小囊样不强化区。5例伴有腹腔积液,2例卵黄囊瘤网膜不规则增厚。无性细胞瘤伴盆腔和腹膜后淋巴结肿大,其他病例均无淋巴结肿大。结论:结合临床表现、术前肿瘤标记物检测及MRI表现有助于卵巢恶性生殖细胞肿瘤的正确诊断及鉴别诊断。

MRI Diagnosis of Ovarian Malignant Germ Cell Tumors

Objective: To investigate the clinical symptoms and MRI features of ovarian malignant germ cell tumors. Methods: Clinical data and MRI images of seven cases with ovarian malignant germ cell tumors confirmed by operation and pathology were retrospectively analyzed, including 1 case of dysgerminoma, 3 cases of yolk sac tumor, 2 cases of immature teratoma and 1 case of mixed germ cell tumor. Results: The clinical symptoms of 7 patients were 1 case of abdominal pain, 3 cases of abdominal mass and 3 cases of abdominal distension. Tumor markers levels: AFP was significantly increased in 6 cases; CA125 was elevated in 3 cases. MRI features: All the tumors were unilateral lesions, including 4 on the right side and 3 on the left side. There were 6 cases of quasi-circular shape and 1 case of lobular shape, the boundary is clear. The maximum diameter of all lesions is greater than 9cm. One case of dysgerminoma was mainly composed of solid components, while the other 6 cases were cystic. 1 case of dysgerminoma saw low signal separation, 2 cases of immature teratoma saw small cystic fluid signal area, and scattered fat signal. Enhanced scanning: 1 case of dysgerminoma was moderately enhanced, with continuous enhancement separation. In 6 cases, the solid part of cystic neoplasm was continuously strengthened, 3 cases of yolk sac tumor showed "honeycomb sign", and 2 cases of immature teratoma showed multiple cystic unenhanced areas. There were 5 cases with peritoneal effusion and 2 cases with yolk sac tumor with irregular thickening of the omentum. In one case, dysgerminoma was accompanied by pelvic and retroperitoneal lymph node enlargement, but no lymph node enlargement was observed in other cases. Conclusions: Combined with clinical manifestations, preoperative tumor marker detection and MRI features, it is helpful for the correct diagnosis and differential diagnosis of ovarian malignant germ cell tumors.