腹部原始神经外胚层肿瘤CT特征  

CT features of abdominal primitive neuroectodermal tumors

作　　者：陈瑞楠 林达 王旭荣 CHEN Ruinan;LIN Da;WANG Xurong(Department of Radiology,Yueqing People’s Hospital of Zhejiang,Yueqing 325600,China;Department of Radiology,Wenzhou People’s Hospital of Zhejiang,Wenzhou 325000,China)

机构地区：[1]浙江省乐清市人民医院放射科,浙江乐清325600 [2]浙江省温州市人民医院影像科,浙江温州325000

出　　处：《医学影像学杂志》2024年第10期92-95,共4页Journal of Medical Imaging

摘　　要：目的探讨腹部原始神经外胚层肿瘤(PNET)的CT特征,以提高对其的认识与诊断正确率。方法选取经病理确诊的19例(共35个肿块)PNET患者临床、病理与CT检查等资料,主要观察肿瘤部位、数目、大小、生长方式、范围、界限、密度、增强表现及周围侵犯与转移等。结果CT平扫表现:19例中肿块位于腹膜后8例,腹、盆腔11例;肿块最大径平均(8.6±5.8)cm。35个肿块平扫均呈不均匀低密度,其中25个肿块内有坏死、囊变;10个肿块内有条状、片状钙化灶。增强CT表现:动脉期肿块显著强化7个,中度强化15个,轻度强化13个;其中12个肿块内见网格状或条片状强化,肿块边缘不光整;11个肿块周围伴有增粗增多血管影。门静脉期肿块中度强化13个,持续轻度强化22个,其中12个肿块内见条片状或网格状持续强化。延迟期肿块轻度强化8个,强化缓慢退出27个。19例均有腹腔、腹膜后淋巴结肿大,其中肠壁增厚11例,腹膜多发结节10例,侵犯输尿管3例,骨转移3例,肝转移2例。结论PNET患者CT平扫以不均匀低密度肿块、坏死囊变、伴条片状钙化,周围组织侵犯而界限不清,远处转移,增强轻中度逐渐性不均匀强化为特点。Objective To investigate the CT features of primitive neuroectodermal tumors of the abdomen.Methods 19 patients with abdominal primitive neuroectodermal tumors confirmed by pathology for clinical,pathological,and CT examination findings were selected in this work.We mainly observed the location,number,size,growth pattern,range,boundary,density,enhancement manifestation,and surrounding invasion and metastasis of the tumor.Results Flat scan performance was as follows:there were a total of 35 masses in 19 cases,including 8 located retroperitoneum and 11 in the abdomen and pelvis.The average maximum diameter of the mass was(8.6±5.8)cm.35 masses showed uneven low-density on plain scan,of which 25 masses had necrosis and cystic changes,and 10 masses had strip or patchy calcifications.Enhanced performance was as follows:there were 7 significantly enhanced masses in the arterial phase,15 moderately enhanced masses,and 13 mildly enhanced masses.Among them,12 masses showed grid like or patchy enhancement,and the edges of the masses were not smooth;11 masses were accompanied by thickened and increased vascular shadows around them.13 masses presented with moderate enhancement and 22 masses with continuous mild enhancement in the portal phase.Among them,12 masses showed continuous enhancement in a patchy or grid like pattern.8 tumors showed mild enhancement during the delayed phase,and 27 tumors showed slow withdrawal of enhancement.All 19 cases had enlarged abdominal and retroperitoneal lymph nodes,including 11 cases of intestinal wall thickening,10 cases of multiple peritoneal nodules,3 cases of ureteral invasion,3 cases of bone metastasis,and 2 cases of liver metastasis.Conclusion The plain CT scan of abdominal primitive neuroectodermal tumor shows heterogeneous low-density mass,necrotic cystic degeneration,with striped calcification,invasion of surrounding tissues with unclear boundaries,distant metastasis and the enhancement is characterized by mild to moderate gradual inhomogeneous enhancement.

关 键 词：腹部和腹膜后 原始神经外胚叶肿瘤 体层摄影术 X线计算机 

分 类 号：R735.5[医药卫生—肿瘤] R814.42[医药卫生—临床医学]