原发性腹膜后平滑肌肿瘤的MSCT诊断及鉴别诊断

发布时间：2018-05-20 02:37

本文选题：腹膜后间隙 + 平滑肌瘤　；参考：《放射学实践》2017年02期

【摘要】：目的:探讨原发性腹膜后平滑肌瘤(RLM)、平滑肌肉瘤(RLMS)的MSCT表现及鉴别诊断。方法:回顾性分析10例经手术病理证实的腹膜后平滑肌肿瘤的临床资料及MSCT征象,并结合文献,总结其影像学表现。结果:3例RLM均位于腹主动脉旁,呈软组织密度,边界清楚,密度均匀。7例RLMS中,位于腹膜后左侧3例,右侧3例,中线区1例;其中5例病灶最大径11cm;4例边界清楚,3例见邻近结构受侵;密度不均匀,坏死囊变多见,其中6例见中心性地图样坏死,1例伴瘤栓形成。CT三期增强扫描:3例RLM呈均匀渐进性强化,7例RLMS的实性成分呈边缘性不规则厚壁状及分隔样渐进性强化,坏死囊变成分未见强化。结论:腹膜后平滑肌肿瘤CT三期增强扫描呈渐进性强化,结合肿瘤的体积、形态、边界、密度、是否伴有中心性地图样坏死、钙化、邻近结构关系及血管受侵等有助于进一步鉴别RLM及RLMS。
[Abstract]:Objective: to investigate the MSCT findings and differential diagnosis of primary retroperitoneal leiomyoma. Methods: the clinical data and MSCT findings of 10 cases of retroperitoneal smooth muscle tumors confirmed by surgery and pathology were analyzed retrospectively. Results all the 3 cases of RLM were located near the abdominal aorta with soft tissue density and clear boundary. In 7 cases of RLMS, 3 cases were located on the left side of peritoneum, 3 cases were on the right side, and 1 case was in the midline area. In 5 cases, the maximum diameter of lesion was 11 cm ~ (-1). 4 cases had clear border and 3 cases had invasion of adjacent structure, density was uneven, necrotic capsule became more common, In 6 cases, central map like necrosis was seen in 1 case with thrombus formation. Ct 3 cases showed homogeneous and progressive enhancement of RLM. 7 cases of RLMS showed marginal irregular thick-wall enhancement and septal progressive enhancement, and the necrotic sac was not enhanced. Conclusion: retroperitoneal smooth muscle neoplasms showed progressive enhancement with progressive enhancement, combined with volume, shape, boundary, density, central map necrosis and calcification. The relationship between adjacent structures and vascular invasion is helpful for the further differentiation of RLM and RLMS.
【作者单位】：泸州医学院附属医院放射科;
【分类号】：R735.4;R730.44

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