腹膜后乏脂肪脂肪肉瘤的CT诊断  

CT diagnosis of retroperitoneal liposarcoma with minimal fat

作　　者：孙芮 苗春萌 于华龙[1] 张传玉[1] SUN Rui;MIAO Chunmeng;YU Hualong;ZHANG Chuanyu(Department of Radiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266003 [2]青岛市妇女儿童医院医学影像科

出　　处：《青岛大学学报(医学版)》2024年第6期925-929,共5页Journal of Qingdao University(Medical Sciences)

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.17558)。

摘　　要：目的分析腹膜后乏脂肪脂肪肉瘤的CT表现,提高对其认识。方法回顾性收集35例我院手术后经病理证实为腹膜后脂肪肉瘤病人的临床信息及三期增强CT资料,分析其特点。结果35例病人中,大部分肿瘤主体位于右肾区(34.3%),肿瘤最大径范围为3.0~30.5 cm,病理结果显示去分化脂肪肉瘤占比最高(28例,80.0%)。三期增强CT示肿瘤内软组织密度部分呈渐进性强化特点者占88.6%。根据肿瘤数目、密度将肿瘤分为以下3型:Ⅰ型(软组织密度为主)5例(14.3%),所有病人肿瘤内软组织成分呈渐进性强化特点;Ⅱ型(囊性密度为主)11例(31.4%),其中10例病人肿瘤内软组织成分示絮状、分隔状渐进性强化;Ⅲ型(软组织与囊性密度混合)19例(54.3%),肿瘤内软组织成分呈延迟性强化,内部低密度区无强化。结论腹膜后乏脂肪脂肪肉瘤在CT上呈现一定规律及特点,仔细观察有助于提高诊断准确率。Objective To investigate the CT findings of retroperitoneal liposarcoma with minimal fat,and to improve the understanding of this disease.Methods A retrospective analysis was performed for the clinical data and three-phase contrast-enhanced CT data of 35 patients with pathologically confirmed retroperitoneal liposarcoma after surgery in our hospital,and their features were analyzed.Results Among the 35 patients,most tumors were located in the right renal region(34.3%),and maximum tumor diameter ranged from 3.0 to 30.5 cm.Pathological results showed that dedifferentiated liposarcoma accounted for the highest proportion of 80.0%(28 patients).Three-phase contrast-enhanced CT showed that 88.6% of the patients had progressive enhancement of the soft tissue density within the tumor.According to the number and density of the tumor,the patients were classified into the following types:type Ⅰ tumor(soft tissue density dominated)in 5 patients(14.3%)with progressive enhancement of the soft tissue component of the tumor;type Ⅱ tumor(cystic density dominated)in 11 patients(31.4%),among whom 10 patients had flocculent and segregated progressive enhancement of the soft tissue component of the tumor;and type Ⅲ tumor(soft tissue mixed with cystic density)in 19 patients(54.3%)with delayed enhancement of the soft tissue component of the tumor,with no enhancement of the internal hypodense area.Conclusion Retroperitoneal liposarcoma with minimal fat has certain patterns and features on CT,and careful observation can help to improve diagnostic accuracy.

关 键 词：腹膜后肿瘤 脂肪肉瘤 体层摄影术 X线计算机 

分 类 号：R735.4[医药卫生—肿瘤] R738.6[医药卫生—临床医学]