腹膜后平滑肌肉瘤CT诊断及文献复习

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上传时间：2015-04-15
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腹膜后平滑肌肉瘤CT诊断及文献复习

【摘要】目的探讨腹膜后平滑肌肉瘤及其肝转移的CT表现,提高CT诊断准确性。方法手术病理证实3例腹膜后平滑肌肉瘤,复习病理基础和文献资料,分析探讨肿瘤原发灶、肝转移灶CT特点讨论其诊断和鉴别诊断。结果影像表现主要是不规则或圆形软组织肿块,部分或全部边缘模糊,中心囊变。增强扫描呈中等或明显延迟性强化,肝转移灶出现类似延迟性等密度充填。结论腹膜后平滑肌肉瘤CT表现特点为巨大占位性肿块,中心囊变呈液性密度,周缘性环状延迟性强化,具有血管受侵倾向,肝转移瘤可以出现于原发灶相同类型强化特征。

【Abstract】 Objective The discuss retroperitoneal smooth myosarcoma and the liver shift the CT performance,enhances the CT diagnosis accuracy.Methods The surgery pathology confirmed that 3 example retroperitoneal smooth myosarcoma,the review pathology foundation and the literature material,the analysis discussion tumor primary stove,the liver shift the stove CT characteristic to discuss its diagnosis and the differential diagnosis.Results The phantom performance was mainly anomalous either the circular soft tissue tumour,the part or the complete edge blurry,the central capsule changed.The enhancement scanning assumed medium or the obvious retardance strengthend,the liver shifted the stove to present the similar retardance equilibrium density backfill.Conclusion The retroperitoneal smooth myosarcoma CT performance characteristic for the giant perch tumour,the central capsule changes assumes the fluidity density,the boundary ring-like retardance strengthens,has the blood vessel to invade the tendency,the liver shifts the lump to be possible to appear in the primary stove same type strengthening characteristic.

【Key words】Leiomyosarcoma; Retroperitoneal; Housing level photography X computer

腹膜后原发性肿瘤占全身肿瘤的0.1%~0.2%,其中80%为恶性。平滑肌肉瘤占腹膜后恶性肿瘤的第三位约1%。原发性腹膜后平滑肌肉瘤是罕见的深部软组织肿瘤,国内外相关研究论著较少[1],作者回顾性分析本组腹膜后平滑肌肉瘤的CT表现,结合病理复习文献,旨在提高对该病的诊断能力。

1 材料与方法

1.1 一般资料与检查方法回顾性总结我院2008~2009年3例腹膜后平滑肌肉瘤、均经手术病理证实。男性2例、女性1例。年龄40~52岁。1例伴肝转移。全部病例以腹部包块就诊,1例伴有腰痛。采用飞利浦单层螺旋CT扫描。检查前常规准备腹部。本组均平扫加增强扫描。增强扫描采用杨子江药业的欧苏[300 (mgl/ml)]非离子造影剂。团注75~100 ml,注射速度2.5~3.0 ml/s,分别于团注后20秒(动脉期)、60秒(静脉期)、3 min延迟期进行扫描。

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