腹膜后纤维化CT误诊原因分析  

Analysis of CT Misdiagnosis of Retroperitoneal Fibrosis

作　　者：陈亚晗 曹倩 万钰磊 徐莹 秦杨 李鸿波[1] CHEN Yahan;CAO Qian;WAN Yulei;XU Ying;QIN Yang;LI Hongbo(Department of Radiology,the Sixth Hospital of Wuhan City Affiliated to Jianghan University,Wuhan 430015,China)

机构地区：[1]武汉市第六医院江汉大学附属医院放射科,武汉430015

出　　处：《临床误诊误治》2023年第3期1-5,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 分析腹膜后纤维化(RPF)的CT误诊原因,以提高影像学医师对本病的认识。方法 对2009年1月—2020年12月CT误诊的18例RPF的临床资料进行回顾性分析。结果 18例均因出现腰背部疼痛不适就诊,CT诊断均误诊。误诊为腹主动脉大动脉炎5例、输尿管肿瘤5例、腹膜后转移性淋巴结增大4例、腹膜后团块性质及来源不明4例。误诊时间1~3.5 d。均经病理确诊RPF。13例病情较重者给予手术治疗,5例病情较轻者给予药物治疗。4例因肿瘤复发或转移死亡,余14例预后较好。结论 RPF主要特点为包绕主动脉及输尿管,导致受累水平以上的尿路梗阻,因此,在影像检查工作中发现主动脉周围包绕软组织团块时,应想到本病,确诊需病理学检查。Objective To analyze the causes of CT misdiagnosis of retroperitoneal fibrosis(RPF),so as to improve the understanding of imaging physicians of this disease.Methods A retrospective analysis was performed on the clinical data of 18 patients with RPF misdiagnosed by CT in our hospital from January 2009 to December 2020.Results All 18 cases presented with pain and discomfort in the back,and misdiagnosed by CT.Misdiagnosis included abdominal aorta arteritis in 5 cases,ureteral tumor in 5 cases,retroperitoneal metastatic lymph node enlargement in 4 cases,and retroperitoneal masses with unknown nature and origin in 4 cases.The duration of misdiagnosis was 1-3.5 d.RPF was confirmed by pathology.Of them,13 patients with severe illness were treated with surgery,and 5 patients with mild illness were treated with drugs.Four patients died of tumor recurrence or metastasis,and the remaining 14 patients had a good prognosis.Conclusion The main feature of RPF is that it surrounds the aorta and ureter,leading to urinary obstruction involved.Therefore,when the soft tissue mass around the aorta is found during imaging examination,this disease should be considered,which needs to be confirmed by pathological examination.

关 键 词：腹膜后纤维化 计算机体层摄影 误诊 腹主动脉大动脉炎 输尿管肿瘤 

分 类 号：R572.2[医药卫生—消化系统]