膀胱平滑肌瘤的非典型CT表现及病理学特点对照分析  

A comparative study of the atypical CT findings and pathological features of bladder leiomyoma

作　　者：秦燕[1] 周顺科[2] 刘军[2] 徐燕[2] 张斌[2] 肖煜东[2] 刘欢[2] 

机构地区：[1]中南大学湘雅医院放射科 [2]中南大学湘雅二医院放射科,长沙410011

出　　处：《中华泌尿外科杂志》2015年第12期895-898,共4页Chinese Journal of Urology

摘　　要：目的 通过对膀胱平滑肌瘤的不典型CT表现与病理学特点对照分析,探讨膀胱平滑肌瘤的非典型CT表现及病理学特点的对应关系.方法 回顾性分析2007年3月至2013年5月经手术病理检查确诊的9例膀胱平滑肌瘤患者的非典型CT表现及病理图像资料.9例患者均为女性,年龄27-53岁,平均38岁.9例均行CT平扫及增强扫描,并行手术治疗.结果 肿块按CT表现分为类似恶性肿瘤征象（3例）、明显不均匀强化实性肿块（5例）以及轻度强化实性肿块（1例）.CT表现为类似恶性肿瘤征象者病理表现为肿瘤体积大,肿瘤细胞明显间质水肿,红色变性,囊变及间质内有明显增粗迂曲的供血血管增生;CT表现为明显不均匀强化实性肿块者病理表现为肿瘤体积适中,可见较明显的间质水肿及变性,间质内有明显增粗迂曲的供血血管增生;CT表现为轻度强化实性肿块者病理表现为肿瘤细胞轻度间质水肿、变性,间质内未见明显增粗迂曲的供血血管增生.结论 膀胱平滑肌瘤的非典型CT表现与病理学特点有一定的相关性.Objective To investigate the relationship between the atypical CT findings and pathological features of bladder leiomyoma.Methods A retrospective analysis of the CT findings and pathological features was conducted in 9 cases of atypical bladder leiomyoma.All the 9 cases were females aged 27 to 53 years （average 38 years）.All patients had plain and enhanced spiral CT scans and were treated surgically.Results The atypical CT findings of bladder leiomyomas showed as similar malignant tumor signs （n =3）,solid mass with obvious inhomogeneous enhancement （n =5） and solid mass with no enhancement （n =1）.All cases had lesions appearing as solid lobulated cystic mass in different degrees,whose solid part showed intermediate density on CT,with heterogeneous enhancement after contrast agent injection.Tumor cell and interstitial cell swelling to varying degrees,vascular hyalinosis,myxoedema,hyalinosis and cystic degeneration were found in these lesions.CT findings showed the consistency with similar malignant tumor signs and pathological showed bigger tumor volume,obvious interstitial edema,red degeneration,cystic degeneration and significantly increasing enlargement circuitous blood vessels.While the CT findings of the obvious inhomogeneous enhancement solid mass and pathological showed moderate tumor size,relatively obvious interstitial edema and cystic degeneration,significantly increasing enlargement circuitous blood vessels were consistent.The consistency was found among mild enhancement solid tumors and pathological showed mild interstitial edema,mild degeneration and no enlargement circuitous blood vessels.Conclusion Through the contrast analysis,atypical CT performance and pathological features might have some certain correlation.

关 键 词：膀胱肿瘤 平滑肌瘤 诊断 体层摄影术 X线计算机 病理学特点 

分 类 号：R737.14[医药卫生—肿瘤] R730.44[医药卫生—临床医学]