原发性腹膜后恶性肿瘤(医学影像学杂志)解析.docVIP

原发性腹膜后恶性肿瘤的CT表现及其应用价值 代茂良1，苟文静2，周瀚1＊Value of MSCT DAI Maoliang，GOU Wenjing，ZHOU Han，et al． Department of Medical Imaging, The third Peoples Hospital of Chengdu, Chengdu 610036，P．R．China 【Abstract】 Objective To discuss the appearances and evaluate diagnostic value of MSCT in Primary Retroperitoneal malignant Tumors. Materials and Methods The CT imaging findings of 28 cases with Primary Retroperitoneal malignant Tumors proven by pathology were analyzed retrospectively. All cases were undergone conventional and contrast enhancement scanning with MSCT preoperatively. Results (1) Of the 28 Primary retroperitoneal malignant Tumors, the accuracy of CT localization and qualitative diagnosis were 82.1% and 46.4% respectively. (2) Fat composition was found in 80%（8/10）cases of liposarcoma, ystic degeneration was found in 100%（6/6）cases of malignant neurogenic tumors. (3) appearance of the surrounding tissue and vascular invasion were found in 60.7%（17/28） cases . The halo sign” were found in 4 cases, metastasis of lymph nodes and distant organs were found in 4 and 3 cases respectively. The tumors with heterogeneous enhancement of 96.4% (27/28) cases were found in enhancement CT scanning. Conclusion It is good enough to reveal tumor location and still difficult to determin pathologic types of Primary Retroperitoneal malignant Tumors with MSCT scanning preoperatively. But some imaging findings, such as fat composition in liposarcoma, cystic degeneration in neurogenic malignant tumor, have great value to estimate histological origin of tumors. 【key words】 Retroperitoneal space; Malignant tumor; Tomography, X-ray computed 原发性腹膜后肿瘤（primary retroperitoneal tumor，PRPT）是一类较为少见的肿瘤的总称，其发病率占全身肿瘤的0.07% ～ 2.00%［1］。PRPT 种类繁多，发病率极低，影像表现缺乏一定特异性，是影像学诊断的难点之一[2] ，尤其是肿瘤良恶性的诊断较为棘手。笔者回顾性分析经病理证实的28例原发性腹膜后恶性肿瘤患者的CT 表现, 旨在提高对腹膜后恶性肿瘤的认识, 以期为临床明确诊断、选择治疗方法、采取手术方式及术前准备提供参考。 1 资料与方法 1.1 临床资料 搜集重庆医科大学附属成都第二临床学院成都市第三人民医院自2006 年5月到2013 年11 月及四川省医学科学院四川省人民医院自2009 年6月至2014年5月经病理证实的原发性腹膜后恶性肿瘤共28 例