What are the diagnostic tests for ovarian teratoma

Ovarian teratoma is a common ovarian germ cell tumor. It is common in women of childbearing age. So, what are the diagnostic tests for ovarian teratoma? Experts say that surgical pathological examination is the gold standard for diagnosis. Clinically, it should be differentiated from pelvic inflammatory tumors, endometriosis, uterine subserosal fibroids, corpus luteum rupture, appendicitis and other diseases.

The diagnostic tests for ovarian teratoma are as follows:

1. MR manifestations

1. The signal intensity of the liquid fat part of the tumor shows short T1 and long T2 signals, which is the main basis for diagnosing teratoma.

2. There are mainly two structures inside the tumor: debris and wall protrusions. The wall protrusions are composed of lipid tissue, hair, teeth, and bones. Debris is often located in the lower layer of the cystic part, and liquid fat is located in the upper layer to produce layered signals. The signal intensity of debris and wall protrusions is roughly medium signal. The signal of lipid is very high on T2-weighted images, the signal of hair is lower than that of muscle tissue, and there is no signal from bones and teeth.

3. Chemical shift artifacts caused by fat can appear both inside the tumor and around the tumor. This feature can be distinguished from hemorrhagic lesions.

CT manifestations

1. The typical CT sign is a cystic mass with uneven density, which may be unilateral or bilateral.

2. The thickness of the cyst wall is uneven and the edge is smooth.

3. Contains fat density shadows and underdeveloped bones and teeth, and solid nodular shadows protruding from the cyst wall. If the cyst contains both fat and liquid, a liquid-fat interface with fat above and liquid below can be seen, and the position can change with changes in body position.

4. In the case of dermoid cysts, CT scans only show cystic masses containing fluid, but the cyst wall may have eggshell-like calcification.

5. When a malignant teratoma invades adjacent tissues, the fat layer between the tumor and surrounding organs disappears. When a tumor invades the bladder, pelvic muscles, or intestinal tract, the boundary between them becomes unclear.

3. Ultrasound manifestations

Most mature teratomas have clear boundaries, complete capsules and smooth contours. The fat and oily substances in the tumor present homogeneous, dense and small light spots, which partially or completely cover the cystic cavity. When fat and mucosity and serous fluid are in the same cystic cavity, a level of enhanced echo can be seen, called the liquid fat surface. When there is hair, spherical or hemispherical light masses can be seen, accompanied by acoustic shadows or acoustic attenuation. The hair light masses in the liquid have a floating feeling. Bones, teeth and cartilages present strip-like strong echoes, accompanied by acoustic shadows or acoustic attenuation. The substantial part presents an inhomogeneous solid mass with diffusely distributed medium or strong echoes.

Plain film manifestations: Specific ossification and calcification, or teeth, may be found. Shell-like calcification may appear on the tumor wall, and low-density translucent shadows may appear inside the tumor.

CT and MRI have obvious advantages in diagnosing teratomas, and both can better show the heterogeneity of tumors. On MRI images, teratomas appear as mixed signals, often with intact cyst walls, rich in fat signals, with or without intratumoral enhancement nodules, and usually, in addition to the tumor, are often accompanied by spina bifida or vertebral dysplasia.

Warm reminder: ECT is currently the most important nuclear medicine instrument. It combines gamma photography, mobile whole-body imaging and tomography, and is mainly used for functional imaging diagnosis of various diseases.