原发性腹膜后恶性肿瘤的CT表现及其应用价值  

Primary retroperitoneal malignant tumors:imaging characteristics and diagnostic value of MSCT

作　　者：代茂良 苟文静[2] 周瀚[1] 高靳[1] 董景彦[3] 须民欣 

机构地区：[1]重庆医科大学附属成都第二临床学院成都市第三人民医院医学影像科,四川成都610036 [2]四川省医学科学院四川省人民医院医学影像科,四川成都610000 [3]成都大学附属医院神经外科,四川成都610000

出　　处：《医学影像学杂志》2015年第12期2184-2188,共5页Journal of Medical Imaging

摘　　要：目的探讨原发性腹膜后恶性肿瘤的CT表现及其应用价值。方法回顾性分析经病理证实的28例原发性腹膜后恶性肿瘤的CT资料。28例均行CT平扫+增强扫描。结果①28例中,23例CT定位与手术部位相符合,定位的准确性为82.1%,13例CT定性结果与病理组织学结果完全相符,准确性为46.4%;②80%(8/10)的脂肪肉瘤可见脂肪成分,100%(6/6)的恶性神经源性肿瘤均可见囊性变;③28例中,CT显示有17例向周围组织与血管侵犯,有4例出现"晕征",有淋巴结转移4例,远处转移3例,27例呈不同程度的不均匀强化。结论 MSCT对肿瘤的定位诊断准确率很高,应作为首选影像学检查方法;MSCT对肿瘤的定性诊断也有一定的价值:脂肪成分对脂肪肉瘤的诊断价值很高,囊性变对恶性神经源性肿瘤的诊断提示较大。Objective To discuss the imaging appearances and to evaluate diagnostic value of MSCT in primary retroper- itoneal malignant tumors. Methods The CT imaging findings of 28 cases with primary retroperitoneal malignant tumors proven by pathology were analyzed retrospectively. All cases underwent conventional and contrast enhancement scanning with MSCT preoperatively. Results ① Of the 28 Primary retroperitoneal malignant Tumors, the accuracy of CT localiza- tion and qualitative diagnosis were 82.1 % and 46.4 % respectively;②Fat composition was found in 80 % （8/10）cases of li- posarcoma, cystic degeneration was found in 100% （6/6） cases of malignant neurogenic tumors; ③ The appearance of the surrounding tissue and vascular invasion were found in 60.7%（17/28） cases. The ＂halo sign＂ was found in 4 cases, me- tastasis of lymph nodes and distant organs were found in 4 and 3 cases respectively. The tumors with heterogeneous en- hancement of 96. 4% （27/28） cases were found in enhancement CT scanning. Conclusion It is good enough to reveal tumor location and still difficult to determine pathologic types of primary retroperitoneal malignant tumors with MSCT scanning preoperatively. But some imaging findings, such as fat composition in liposarcoma, cystic degeneration in neuro- genic malignant tumor, have great value to estimate histological origin of tumors.

关 键 词：腹膜后间隙 恶性肿瘤 体层摄影术 X线计算机 

分 类 号：R735.4[医药卫生—肿瘤] R814.42[医药卫生—临床医学]