腹部原发去分化脂肪肉瘤CT表现及病理对照分析  

CT findings of primary abdominal dedifferentiated liposarcoma： a comparative analysis with pathology

作　　者：林红东[1] 张志艳 马伟琼[1] 周玉祥[1] 

机构地区：[1]惠州市中心人民医院放射科,广东惠州516001

出　　处：《实用放射学杂志》2018年第2期226-229,共4页Journal of Practical Radiology

摘　　要：目的 探讨腹部原发去分化脂肪肉瘤（DDL）CT特征，提高诊断准确率。方法 回顾性分析经手术病理证实23例腹部原发DDL的CT影像特征，并与其病理对照分析。结果 23例中20例位于腹膜后，2例位于腹腔，1例位于盆腔腹膜外，肿块平均直径约26.5 cm；根据CT图像特征，原发病灶包括了脂肪区和非脂肪区；其中21例非脂肪区表现为单发肿块，位于含脂肪区边缘或表面;2例非脂肪区表现为多发肿块，部分位于脂肪区内部，两者分界清晰；21例含脂肪区以混浊脂肪密度为主，可见条状、网状分隔，2例含脂肪区表现以稍低密度为主，内夹杂散在脂肪密度，增强后含脂肪区无强化，分隔轻度强化;20例非脂肪区表现为软组织密度肿块，增强后轻中度不均匀强化;3例为介于液体与软组织之间密度肿块，增强后片絮状强化，以延迟期明显;4例可见斑点状钙化。结论 腹部原发DDL的CT表现具有一定特征，不同去分化成分形成不同的影像特点，仔细观察非脂肪性肿块周边是否存在高分化脂肪成分，对提高本病诊断准确率、减少误诊有重要价值。Objective To investigate the CT findings of primary abdominal dedifferentiated liposarcoma（DDL） ,and to improve the diagnostic accuracy.Methods CT images of 23 cases with primary abdominal DDL confirmed by pathologically were analyzed retrospectively,and the CT findings were compared with pathological results.Results The masses in 20 cases out of 23 cases were located in retroperitoneal region, 2 in abdominal cavity and I in the pelvic extraperitoneal space. The mean diameter of the masses was 26.5 cm. CT showed the fatty and non-fatty regions in the masses. In 21 cases,the non-fatty region was manifested as a single mass and was located at the edge or on the surface of fatty region. In 2 cases,the non-fatty region was manifested as multiple well-defined masses and was located within the fatty region. In 21 cases, the fatty region showed misty density with strip and reticular septa. In 2 other cases, the fatty region showed slightly low density, mingled with some fat tissue density, which showed no enhancement with mild enhanced internal septa. In 20 cases, the non-fatty region showed soft tissue density, with mild to moderate heterogeneous enhancement. In 3 other cases,the density of non-fatty region varied between liquid and soft tissue with patchy enhancement on delayed phase.In addition,stippled calcification was found in 4 cases.Conclusion The primary abdominal DDL has relatively specific CT findings, which different dedifferentiated components pro duce different CT characterizes.Finding well-differentiated fat components around non-fatty mass may help to improve the accuracy of diagnosis and reduce the misdiagnosis.

关 键 词：去分化脂肪肉瘤 腹部 计算机体层成像 病理学 

分 类 号：R738.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]