| Aim: The aim of the present study was to analyze the MRI feature and clinical characteristics of ovarian thecoma as well as to identify their correlations with pathological appearance of ovarian thecoma, expecting to improve the diagnostic accuracy of ovarian thecoma.Materials and Methods: We studied the clinical data and MRI appearance of the pathological confirmed ovarian thecoma in 30 patients retrospectively, by analyzing the MRI appearance of ovarian thecoma(that include the location, size, shape and border of ovarian thecoma, whether the cystic degeneration and bleeding were present, the characteristics of plain scanning and pattern of enhancement, the association of ovarian thecoma with the adjacent tissue and lymph nodes) and comparing it with its pathological characteristics.Results: A total of 32 lumps were identified in 30 patients that included 28 patients with the lumps presented in either side of pelvic cavity and 2 patients with the lumps presented in both side of pelvic cavity. The maximum diameter of the lumps ranged from 10 mm to 238 mm. The border of each lump was clear and its tunica was complete.The shape was quasi-circular in 17 lumps, irregular in 8 lumps and lobulated in 7 lumps. 16 lumps were solid and 16 lumps were cystic-solid mass. The plain scanning of MRI indicated that the solid portion of the lump presented iso- or hypointense signal intensity on TIWI. The patchy attenuation of MRI signal in opposed-phase was seen in 9 lumps when compared with that in the in-phase. However the patchy enhancement of signal in out-phase was presented in 2 lumps when compared with the in-phase. The cyst portion of lumps was presented as hypointense signal intensity on TIWI. On T2 WI, the solid portion of lump was presented as mixed hypo and hyperintensity in 17 lumps, isointensity in 7 lumps(5 lumps showed the isointensity mixed with some hypointensity), hypointensity in 5 lumps(2 lumps showed the hypointensity mixed with some isointensity) and hyperintensity in 3 lumps(a lump showed the hyperintensity mixed with some hypointensity). The cyst portion of lumps was presented as hyperintense signal intensity on T2 WI. The progressive enhancement of solid portion was mild in 9 lumps, modest in 5 lumps, severe in 2 lumps and mild-severe in 16 lumps on contrast-enhanced MRI scan. The enhancements of all lumps were persistent. The shape of cystic portion could be quasi-circular, irregular, elongated and fissured. The cystic portion located peripherally in 7 lumps, centrally in 6 lumps, and both peripherally and centrally in 3 lumps. Some of the cystic portions communicated with each other. A complete capsule was seen in 2 lumps whereas the capsule of the remaining lumps consisted of peripheral mass. The inner wall of capsule was smooth. There was some correlation between cystic degeneration and the size of lumps((rs=0.463, p<0.05), the degree of cystic degeneration increased with the increase of the size of lumps. There were patchy bleeding in 9 lumps, necrosis in 5 lumps, edema in 3 lumps and mucoid degeneration in 1 lump. Moreover the tumor pedicle torsion was seen in 3 patients,the comorbid Meigs syndrome was presented in 2 patients, the moderate volume of ascites was identified in 3 patients and mild pelvic effusion was seen in 25 patients. The positive correlation was significant between the pelvic effusion and the size of lumps( rs=0.617, p<0.05)? The lymphadenectasis was absent in 30 patients.Conclusions: By combing the MRI characteristics of ovarian thecoma(the component of collagen showed hypointensity on T2 WI and persistent progressive enhancement pattern on contrast-enhanced MRI scan) and patients' clinical manifestations, the diagnostic accuracy of ovarian thecoma could be improved. |
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