摘要
目的探讨腹膜后平滑肌肉瘤的CT影像学特征。方法回顾性分析经手术病理证实的10例腹膜后平滑肌肉瘤患者的影像学资料。9例行CT平扫及增强检查,1例行CT直接增强检查。10例均有完整病例结果。结果病变多呈分叶状,6例与下腔静脉关系密切,呈包绕及浸润关系。3例同时累及腹部与盆腔部位。病变体积均较大,大小约6cm×4cm×2.5cm^30cm×20cm×15cm。CT平扫9例呈不均匀软组织密度,1例以囊性为主,伴实性厚壁及厚分隔,增强后明显不均匀强化,8例动脉期强化幅度超过40 HU,静脉期造影剂无明显退出。1例可见邻近腰椎骨质破坏,10例均未见明显肿大淋巴结,未发现远处转移。平滑肌肌动蛋白SMA呈阳性表达,结蛋白Desmin呈现阳性表达,CD117呈现阴性。结论腹膜后平滑肌肉瘤是一种少见的肿瘤,CT有一定的特征性表现,同时可准确定位,确定周围及邻近组织浸润及受累情况等,最终确诊依靠病理免疫组化检查。
Objective To investigate the CT Imaging characteristics of retroperitoneal leiomyosarcoma. Methods Retrospective analysis the imaging datas of 10 cases proved by surgery and pathology with retro- peritoneal leiomyosareoma. We underwent plain and enhanced CT in 9 cases, as well as direct-Enhanced CT in 1 cases. Results The number of women was more than men, which occupy for 70 percent （7/10）. The mean age of the 10 patients was 48 years old. The main feature of the 10 cases was single and leaf- shaped. 3 cases of them were postoperative recurrence. 6 cases were closely related to the inferior vena ca- va, which had an enveloping and infiltration relationship. Lesions are large in size, ranging in size from 6 ×4× 2.5 cm to 30× 20 × 15 cm. 9 cases CT plain scan showed inhomogeneous soft tissue density. 1 case was cystic which had solid thick wall and septum, and enhanced significantly heterogeneous enhancement. 8 ca- ses of arterial phase, the enhanced level were more than 40HU, while venous phase contrast agent had no obvious exit. 1 case destructed the lumbar bone which was closed to the lesion. There were no significant swelling of lymph nodes of 10 cases, no distant metastasis was found. Conclusion Retroperitoneal leiomy- osarcoma is a rare tumor, CT had some characteristic manifestations, as well as defined accurate positio- ning, such as determining the surrounding and adjacent tissue invasion and involvement. The final diagno- sis depended on Immunohistochemical examination.
出处
《新疆医科大学学报》
CAS
2015年第9期1170-1173,1181,共5页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区卫生厅青年科技人才专项科研项目(2013Y12)
关键词
腹膜后平滑肌肉瘤
体层摄影术
CT
retroperitoneal leiomyosarcoma
computed tomography
CT
