盆腹部侵袭性血管黏液瘤的影像学特征与临床病理分析  

Imaging Features and Clinicopathological Analysis of Invasive Angiomyxoma in Pelvic and Perineum

作　　者：孙永灿 钱国珍 张铭 李文杰 张恩龙 SUN Yong-can;QIAN Guo-zhen;ZHANG Ming;LI Wen-jie;ZHANG En-long(Department of Radiology,Peking University International Hospital,Beijing 102206,China;Department of Radiology,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;Department of Pathology,Peking University International Hospital,Beijing 102206,China;Department of Retroperitoneal Tumor Surgery,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院放射科,北京102206 [2]首都医科大学附属北京朝阳医院放射科,北京100020 [3]北京大学国际医院病理科,北京102206 [4]北京大学国际医院腹膜后肿瘤外科,北京102206

出　　处：《中国CT和MRI杂志》2023年第5期124-126,共3页Chinese Journal of CT and MRI

基　　金：北京大学国际医院院内科研基金(YN2019QN03)。

摘　　要：目的 探讨盆腹部侵袭性血管黏液瘤(AAM)的CT、MRI特征与临床病理特征,提高对本病的认识。方法 回顾性收集北京大学国际医院经手术病理证实的盆腹部侵袭性血管黏液瘤14例,3例患者术前行盆部MR平扫及增强扫描,13例行腹盆部CT平扫及增强扫描。女性11例,男性3例,年龄27~57岁,平均年龄38.6岁,分析CT、MRI影像学表现及病理学特征。结果 12例为原发肿瘤,2例为术后复发。12例跨尿生殖膈与盆膈生长,肿瘤最大径约3.5~33.2cm,平均14.2cm。11例肿瘤与周围结构分界清,CT平扫呈低密度,增强扫描11例病变内部可见分层或漩涡样改变。MRI显示T_(1)WI表现低信号,T_(2)WI表现高信号,增强扫描可见“分层”或“漩涡”征。结论 AAM好发于女性的盆腹部,易向盆底组织间隙内延伸、侵袭生长,特征性影像学表现为不均匀渐进性强化,可见“分层”或“漩涡”征,病理上具有肿瘤细胞稀疏、黏液样基质大量存在及局部血管分布丰富等特点。Objective To investigate the CT,MRI and clinicopathological features of pelvic and abdominal invasive angiomyxoma(AAM).Methods 14 cases of pelvic and abdominal invasive angiomyxoma confirmed by surgery and pathology in Peking University International Hospital were collected retrospectively.3 cases underwent plain and enhanced pelvic MR scanning before operation,and 13 cases underwent plain and enhanced abdominal and pelvic CT scanning.11 female and 3 male patients aged from 27 to 57 years,with an average age of 38.6 years,were included in this study.The CT and MRI findings and pathological features were analyzed.Results 12 cases were primary tumors,2 cases were postoperative recurrence,and 12 cases grew across the urogenital diaphragm and pelvic diaphragm.The maximum diameter of the tumor was about 3.5~33.2cm,with an average of 14.2cm.The boundary between tumor and surrounding structure was clear in 11 cases.Plain CT scan showed low density,and enhanced CT scan showed stratified or vortex like changes in 11 cases.MRI showed low signal on T_(1)WI and high signal on T_(2)WI,and“stratification”or“ortex”sign could be seen on enhanced scan.Conclusion AAM often occurs in the pelvic abdomen of women,and is easy to extend,invade and grow into the pelvic floor tissue space.The characteristic imaging manifestations are uneven and progressive enhancement,with“stratification”or“ortex”sign.The corresponding pathological characteristics are sparse tumor cells,a large number of myxoid matrix and abundant blood vessels in local areas.

关 键 词：血管黏液瘤 侵袭性 CT 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]