原发性腹膜后平滑肌肉瘤的MRI表现  

MRI findings of primary retroperitoneal leiomyosarcoma

作　　者：刘珊妹 丁玉芹 陆秀良 侯凯 陈亮 周建军 曾蒙苏 LIU Shanmei;DING Yuqin;LU Xiuliang;HOU Kai;CHEN Liang;ZHOU Jianjun;ZENG Mengsu(Department of Radiology,Zhongshan Hospital Affiliated of Fudan University,Shanghai 200032,China;Department of Radiology,Changzhou No.7 People’s Hospital,Changzhou,Jiangsu Province 213011,China)

机构地区：[1]复旦大学附属中山医院放射科,上海200032 [2]常州市第七人民医院放射科,江苏常州213011

出　　处：《实用放射学杂志》2024年第6期936-939,共4页Journal of Practical Radiology

基　　金：国家自然科学基金青年项目(82202285)。

摘　　要：目的探讨原发性腹膜后平滑肌肉瘤(PRLS)的MRI表现特征。方法回顾性分析33例经病理证实的PRLS病例,并对其多参数MRI表现特征进行定性及定量分析。结果33例PRLS中,24例位于肾门、下腔静脉或髂血管分叉处周围区域。24例有相对完整的包膜,25例有坏死,其中凝固性地图样坏死15例。肿瘤直径3.0~20.7 cm,平均(9.9±5.1)cm,其中直径≥5 cm 27例;33例PRLS肿瘤实质部分扩散加权成像(DWI)呈明显高信号、表观扩散系数(ADC)图呈明显低信号,增强后肿瘤实质部分均呈中等至明显程度的渐进性强化,增强后各期的肿瘤信号值高于腰大肌(P<0.001)。结论PRLS通常瘤体大且有相对完整的包膜,与腹膜后主要静脉关系密切;凝固性地图样坏死、水分子扩散明显受限及渐进性强化方式等均具有一定的MRI特征性。Objective To investigate the MRI features of primary retroperitoneal leiomyosarcoma(PRLS).Methods Thirty-three cases of pathologically confirmed PRLS were analyzed retrospectively,and their multi-parameter MRI features were analyzed qualitatively and quantitatively.Results Of the 33 PRLS,24 cases were located in the renal hilum,inferior vena cava,or the area around the bifurcation of the iliac vessels.Twenty-four cases had relatively intact capsule,25 cases had necrosis,and 15 cases had coagulated geographic necrosis.The mean diameter of the tumors was(9.9±5.1)cm,ranging from 3.0 to 20.7 cm,among which 27 cases with a diameter larger than 5 cm.The tumor parenchyma of the 33 PRLS all showed significantly high signal intensity on diffusion weighted imaging(DWI),and significantly low signal intensity on apparent diffusion coefficient(ADC)map.The tumor parenchyma showed moderate to obvious degree of progressive enhancement,and the signal intensity value of the tumor in each phase after contrast injection was higher than that of the psoas major muscle(P<0.001).Conclusion PRLS are usually large but have a relatively intact capsule and are closely related to the major retroperitoneal veins.The coagulated geographic necrosis,significantly limited diffusion of water molecules,and progressive enhancement pattern all show certain MRI characteristics.

关 键 词：平滑肌肉瘤 腹膜后 磁共振成像 

分 类 号：R735.5[医药卫生—肿瘤] R445.2[医药卫生—临床医学]