腹盆腔促结缔组织增生性小圆细胞瘤磁共振成像检查的影像学特征  

MRI features of desmoplastic small round cell tumor of the abdomen and pelvis

作　　者：翁晓海 潘阿善 冯国飞 周海生 张培贵 余捷 胡明哲 邱乾德 Weng Xiaohai;Pan Ashan;Feng Guofei;Zhou Haisheng;Zhang Peigui;Yu Jie;Hu Mingzhe;Qiu Qiande(Department of Radiology,Yueqing People's Hospital,Yueqing 325600,Zhejiang Province,China;Depart-ment of Pathology,Wenzhou People's Hospital,Wenzhou 325000,Zhejiang Province,China;Depart-ment of Imaging,Wenzhou People's Hospital,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]乐清市人民医院放射科,乐清325600 [2]温州市人民医院病理科,温州325000 [3]温州市人民医院影像科,温州325000

出　　处：《中华消化外科杂志》2023年第2期274-280,共7页Chinese Journal of Digestive Surgery

基　　金：温州市科技局项目(Y2020810)。

摘　　要：目的探讨腹盆腔促结缔组织增生性小圆细胞瘤(DSRCT)磁共振成像(MRI)检查的影像学特征。方法采用回顾性描述性研究方法。收集2008年1月至2022年6月乐清市人民医院收治3例和温州市人民医院收治5例腹盆腔DSRCT患者的临床病理资料;男5例,女3例;年龄为(43±5)岁。患者均行MRI平扫+增强扫描检查。观察指标:(1)腹盆腔DSRCT影像学特征。(2)腹盆腔DSRCT治疗与病理学检查特征。(3)随访情况。正态分布的计量资料以x±s表示,偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)腹盆腔DSRCT影像学特征。①肿瘤部位:8例患者中,肿瘤分别位于右季肋区肝下缘、右髂区回盲部内侧、右髂区盲肠内侧、左季肋区胃胰间隙、左髂区肠系膜间隙、盆腔膀胱右侧各1例,左季肋区腹膜后间隙2例。②肿瘤大小:8例患者有13个病灶,瘤体最大径为9.1(3.5~20.0)cm;其中单发肿瘤5例,多发肿瘤3例。③肿瘤形状与界限:8例患者中,4例肿瘤呈膨胀性生长,4例肿瘤呈侵袭性生长;5例瘤内坏死囊变,4例瘤内出血,4例瘤内见斑点状钙化,3例瘤周渗出改变(同1例患者可合并多种影像学表现)。④MRI平扫检查影像学特征:8例患者中,MRI平扫检查T1加权成像呈均匀低信号4例,低信号中夹杂斑点状高信号(伴出血)4例;T2加权成像(T2WI)呈均匀高信号3例,边缘高信号中央斑片状及斑点状更高信号5例;T2WI脂肪抑制序列呈高、等、低混杂信号5例,呈高、低信号3例;弥散加权成像呈均匀高信号3例,呈高、等、低混杂信号5例。⑤MRI增强检查影像学特征:8例患者MRI检查增强后均呈不均匀强化,其中2例动脉期实质部分显著强化,门静脉期持续强化,延迟期强化程度略降低;4例动脉期实质部分中度强化,门静脉期持续强化,延迟期强化缓慢退出;2例动脉期实质部分轻度强化,门静脉期持续强化,延迟期强化缓慢退出。8例患者中,3例肿Objective To investigate the magnetic resonance imaging(MRI)features of desmoplastic small round cell tumor(DSRCT)of the abdomen and pelvis.Method The retrospec-tive and descriptive study was conducted.The clinicopathological data of 8 patients with DSRCT of the abdomen and pelvis,including 3 cases admitted in Yueqing People's Hospital and 5 cases admitted in Wenzhou People's Hospital,from January 2008 to June 2022 were collected.There were 5 males and 3 females,aged(43±5)years.All patients underwent MRI plain and enhanced scanning.Observa-tion indicators:(1)imaging features of DSRCT of the abdomen and pelvis;(2)treatment and pathological examination characteristics of DSRCT of the abdomen and pelvis;(3)follow-up.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distri-bution were represented as M(range).Count data were described as absolute numbers.Results(1)Imaging features of DSRCT of the abdomen and pelvis.①Tumor location.Of the 8 patients,there were 6 cases with tumors located respectively at the lower edge of the liver in the right quarter costal region,the medial side of the ileocecal region in the right iliac region,the medial side of the caecum in the right iliac region,the gastro-pancreatic space in the left quarter costal region,the mesenteric space in the left iliac region and the right side of pelvic bladder,and 2 cases with tumors located at retroperitoneal space of left quarter rib region.②Tumor size.There were 13 lesions in the 8 patients,and the maximum diameter of tumor was 9.1(range,3.5‒20.0)cm.Of the 8 patients,there were 5 cases with single tumor and 3 cases with multiple tumors.③Tumor shape and boundary.Of the 8 patients,there were 4 cases with tumor in expansive growth and 4 cases with tumor in invasive growth.There were 5 cases with tumor of intratumoral necrosis and cystic degene-ration,4 cases with tumor of intratumoral hemorrhage,4 cases with tumor of intratumoral spot calcification,3 cases with tumor of peritumoral tissue e

关 键 词：肿瘤 促结缔组织增生性 小圆细胞瘤 磁共振成像 诊断 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737[医药卫生—诊断学]