卵巢甲状腺肿的CT诊断及病理对照（附3例报道及文献复习）

目的 探讨卵巢甲状腺肿（SO）的CT诊断价值和临床、病理特点.方法 回顾性分析3例经手术病理证实的卵巢甲状腺肿的临床及CT资料,所有病例均行多排螺旋CT平扫和增强扫描.并结合文献复习卵巢甲状腺肿CT诊断及临床、病理特点.结果 本组3例肿瘤体积较大,长径达8～14 cm.CT平扫表现均表现为囊性或囊实性肿块,边界均清楚,囊壁光滑.囊性部分为单囊或多囊状稍高密度区,实性部分为软组织密度,内见斑点状、斑片状钙化.增强扫描囊性部分无强化,实性部分明显强化.1例伴有甲状腺右叶及右侧腋尖的结节性甲状腺肿.结合文献,以下表现具有一定诊断价值：①单侧边界清楚囊实性肿瘤;②肿块囊性部分多为多囊,囊内密度一般较高,实性部分出现与甲状腺密度类似的软组织影.③实性部分和囊壁常见钙化;④囊壁光滑,一般不会出现壁结节;⑤增强扫描实质部分强化明显;⑥可出现肿瘤标志物异常、甲亢或甲状腺肿症状.结论 CT表现具有一定特征性,对具有典型征象的病例,结合病史和临床检查,基本可以实现诊断;对于不典型的病例最终诊断仍需依靠病理学检查.

MSCT imaging appearance and pathology of struma ovarii (report of 3 cases and literature review)

Objective To evaluate the value of CT diagnosis for struma ovarii （SO）, and discuss the clinical and pathological characteristic. Methods Clinical and CT findings of three patients with struma ovarii proved by operation pathology were analyzed retrospectively. All three cases were received pre-enhanced CT scan and enhanced CT. The literatures for CT diagnosis, clinical and pathological characteristic were reviewed. Results The volume of tumor in the three patients was relatively large （the diameter was 8-14 cm）. On CT imaging, it was showed as the cystic or cyst-solid mass. The boundary was clear and the cyst wall was smooth. The cyst part was single or multi-cyst-shaped within a little higer density area. The solid part was soft tissue density similar to thyroid gland. The spot or patch calcification was seen inside of mass or on the wall of cyst. The solid part was obviously enhanced, while cyst part was not. One patient was combined with nodular goiter. The following characteristics were valuable. （1）There was a unilateral cyst-solid mass with clear edge; （2）The density of content in cyst was a little higher than water, and density of solid part was similar to thyroid gland; （3）Calcification was usually showed inside of mass or on the wall of cyst; （4）The wall of cyst was smooth, and no nodule; （5）Solid part was markedly enhanced; （6） It was usual in patients with abnormal tumor markers, symptoms of hyperthyroidism or goiter. Conclusion Struma ovarii with typical appearance had a certain CT characteristics, and combined with clinical data, most cases could be correctly diagnosed. Diagnosis of atypical cases must be based on histopathology.