双螺旋CT血管造影及三维重建诊断下肢软组织肿瘤  

Imaging diagnosis of lower extremity soft tissue tumor using double-slice spiral computed tomography angiography

作　　者：方先来[1] 贝抗胜[1] 孟志华[1] 李少明[1] 张德[1] 石广兴[1] 徐彤[1] 

机构地区：[1]广东省韶关粤北人民医院影像诊断科,广东韶关512026

出　　处：《中国现代医学杂志》2006年第14期2205-2208,共4页China Journal of Modern Medicine

基　　金：2004年韶关市医药卫生科研计划项目(编号:Y04104)

摘　　要：目的评价双层螺旋CTA及多模式三维重建(MM3DR)诊断下肢软组织肿瘤(LSTT)的价值。方法48例患者以2.0～3.5mL/s从前臂静脉注射含300mgI/mL造影剂(优维显等)80～140mL,延时40～65s行下肢节段性扫描;准直3～7mmHQ,螺距1.2～1.5,1.5～3.5mm间距后重建;资源图像输入AW4.0工作站作MM3DR。28例作动态增强扫描并绘出时间-密度曲线图(TDC)。结果良、恶性肿瘤各为18、30例,其中37例为富血供性肿瘤(占77%);22例恶性肿瘤实体部分增强呈速升-速降型TDC改变,包括横纹肌肉瘤、恶性纤维组织细胞瘤、纤维肉瘤、滑膜肉瘤、脂肪肉瘤、血管肉瘤各6、6、4、3、2和1例。CTA与手术病理对照诊断LSTT的敏感性、特异性和准确性各为90%、100%和83%。结论LSTT的影像表现具有一定特征;CTA及TDC对其诊断与鉴别诊断具有较重要意义。[Objective] To evaluate the clinical value using double-shce spiral CT angiography（CTA） scan and multimodel three-dimensional reconstruction（MM3DR） for diagnosing lower extremity soft tissue tumor（LSTI）. [Methotis] 48 cases were scanned using Hispeed NX/I scanner. A volume of 70～140 mL Ultravist （300 mg Iodine/mL） was injected at rate 2～3.5 mL/s with a scan delay of 40～65 s. Scan data was acquired using 3～7 mm collimation（HQ）, pitch 1.2～1.5 and reconstructed interslice distance 1.5～3.5mm. The source image were transferred to an independent workstation AW 4.0 for MM3DR. 28 cases being scanned using dynamic enhancement scan, their time-density curve（TDC） were displayed. Various signs were analyzed. Imaging findings were compared with the results of post-operated pathology. [Results] Malignant and benign tumors were 30 and 18 eases. 37 eases being nourish-vessel tumors, （78%）. Their dynamic enhancement condition of 22-ease malignant tumors were displayed for ＂sped-ascend and sped descend＂ TDC. These malignant tumors included as follows rhabdosarcoma 6, malignant fibrous histiocytoma 6, fibrosareoma 4, synoviosarcoma 3, liposareoma angiosarcoma 1. The sensitivity, specificity and accuracy of CTA group and post-operative pathology were 90%, 100%, 83%, respectively. [Conclusion] The imaging feature of LSTT were of characteristics. Their diagnosis and differentiated diagnosis can be acquired on CTA and TDC.

关 键 词：CT血管造影 体层摄影术 X线计算机 软组织肿瘤 下肢 

分 类 号：R445[医药卫生—影像医学与核医学]