CTA在巨大外生性腹盆部肿瘤诊断中的价值  

The value of CTA in the diagnosis of giant exophytic abdominopelvic tumors

作　　者：张应和 彭沦 罗东 覃智颖[1] 顾瑞基 谢晓丹 黄汉培 张树勋 ZHANG Yinghe;PENG Lun;LUO Dong;QIN Zhiying;GU Ruiji;XIE Xiaodan;HUANG Hanpei;ZHANG Shuxun(Department of Radiology, Guangdong General Hospital’s Nanhai Hospital, Foshan City, Foshan 528251, P.R.China)

机构地区：[1]广东省人民医院南海医院影像中心,广东佛山528251

出　　处：《医学影像学杂志》2021年第7期1220-1224,共5页Journal of Medical Imaging

基　　金：广东省佛山市科技局医学类科技攻关项目(编号:2018AB001612)。

摘　　要：目的探讨CT血管成像(ct angiography,CTA)在巨大外生性腹盆部肿瘤来源及对周围器官侵犯诊断中的价值。方法分析经手术和病理证实的128例直径大于5 cm的外生性腹盆部肿瘤的CT增强扫描资料,采用容积再现(VR)、最大密度投影(MIP)进行血管重建,分析肿瘤供血动脉和侧支滋养动脉。结果与手术和病理结果对照,128例巨大外生性腹盆部肿瘤CTA均显示了肿瘤来源器官的供血动脉,其中,34例还同时显示了受侵器官来源的侧支滋养动脉,阳性率26.6%(34/128)。供血侧支滋养动脉表现为来源于周围器官的血管,于肿瘤外周进入瘤内,并在瘤体内进一步分支供血肿瘤边缘的少部分区域。结论对于盆腹腔巨大外生性肿瘤,CTA供血动脉可以准确判断肿瘤来源,侧支滋养动脉对判断周围器官受侵具有很高的特异性,但敏感性不高,较难发现早期侵犯的病例。Objective To investigate the value of CT angiography(CTA)in the origin of giant exophytic abdominopelvic tumors and in the diagnosis of peripheral organ invasion.Methods The enhanced CT scanning data of 128 patients with surgically and pathologically confirmed exophytic abdominopelvic solitary tumor over 5cm in diameter invading surrounding organs were analyzed retrospectively.Revascularization was carried out using volume rendering(VR)and maximum intensity projection(MIP).The tumor-feeding artery and collateral nutrient artery of tumors were analyzed.Results Compared with the results of operation and pathology,128 cases of giant isolated abdominal pelvic tumors showed the feeding arteries of the organs of tumor origin on CTA,of which 34 cases also showed the collateral nutrient arteries of the invaded organs,with a positive rate of 26.6%(34/128).Collateral nutrient arteries appeared as blood vessels derived from surrounding organs,entered the tumor in the periphery of the tumor,and further branch in the tumor to supply a small part of the area at the edge of the tumor.Conclusion For large exophytic tumors of the abdominopelvic cavity,CTA feeding artery can accurately determine the origin of the tumor and collateral nutrient artery has a high specificity for judging the invasion of surrounding organs,but the sensitivity is not high,it's difficult to detect early cases of invasion.

关 键 词：肿瘤 腹盆部 侵犯 动脉 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R737.3[医药卫生—放射医学]