腹膜后脂肪肉瘤CT表现特征.docVIP

腹膜后脂肪肉瘤CT表现特征 　【摘要】 目的：探讨腹膜后脂肪肉瘤的CT平扫和增强表现及鉴别诊断要点。方法：回顾12例经手术病理证实的腹膜后脂肪肉瘤的CT平扫和增强资料，12例均行CT平扫，7例加作增强。分析不同组织类型脂肪肉瘤的CT表现与病理的相关性。结果：与病理对照，脂肪瘤样脂肪肉瘤(LLS)1例，硬化性脂肪肉瘤(SLS)1例，黏液样脂肪肉瘤(MLS)1例，圆细胞性脂肪肉瘤(RCLS)1例，去分化脂肪肉瘤(DDLS)1例，混合成分7例。CT图像上，LLS表现为脂肪密度肿块，不均质，有分隔；MLS平扫表现为均匀的水样密度肿块，增强扫描可见网状、片状或岛状强化；RCLS表现为无脂肪的软组织肿块，与其他类型的软组织肿瘤难以鉴别；DDLS表现为明显强化的软组织肿块，常伴有分化良好的脂肪瘤样组织。结论：不同组织学亚型的脂肪肉瘤其CT表现有所不同，CT表现的差异取决于病变内不同组织学亚型的比例、分布及混合的方式。本组中，腹膜后脂肪肉瘤多以混合形式存在，了解这些CT表现特点有助于脂肪肉瘤的术前诊断及分型。 【关键词】 脂肪肉瘤 腹膜后 体层摄影术 X线计算机病理学 　　CT Characteristic Features of Retroperitoneal Liposarcoma Abstract： Objective To discuss the CT manifestation of retroperitoneal Liposarcoma.Methods The CT data of 12 cases retroperitoneal Liposarcoma with verifield by pathology were reviewed retrospectively.To analyze the CT manifestation. 12 cases were examined by CT plain scanning and 7 cases by contrast enhancement scanning preoperatively. Preoperative CT findings were compared with pathological results.The corelation of CT signs of different histological liposarcoma with pathology was studied．Results Pathologically lipomalike liposarcoma(LLS)was seen in 2 patients．while myxoid(MLS)in 1，roundcell(RCLS)in 1，dediferentiated in 1(DDLS)and mixed in 7 CT scans，LIS showed heterogeneous fat density with septum shadow and(MLS) presented water density with reticularorisl andlike enhancement on enhanced scans．RCLS displayed as soft tissue mass containing no fat，which was difficult to be diferentiated with other soft tissue tumors ．DDLS was demonstrated as markedly enhanced soft tissue mass often containing well diferentiated lipoma—like tissue． Conclusion Retroperitoneal liposarcoma of different histologicsubty pecarrieseach own CT characteristics． The CT features depended the proportion，distribution and mixed pattern of diferent components within the lesion． Mixed typeis most of ten seen in this study．The knowledge of liposareoma Sctmanifestations is helpful for the preoperative diagnosis and classification of the disease． 　　Key words： Li