摘要
目的：分析腹膜后异位嗜铬细胞瘤的CT和MR表现，以提高其诊断准确率。方法回顾性分析经手术病理证实的32例有完整临床和影像学资料的腹膜后异位嗜铬细胞瘤患者资料，分析其CT和MR表现。结果32例腹膜后异位嗜铬细胞瘤中，病变位于肾前间隙12例，肾周间隙13例，肾后间隙7例。良性28例，恶性4例。25例患者CT平扫密度不均匀，23例增强扫描后，明显强化者19例，中度强化4例；强化类型中，全部强化9例，实性区域强化12例，边缘强化1例，斑驳样强化1例。23例MR平扫信号不均匀，22例增强扫描后动脉期强化明显，门脉期和延迟期亦强化，其内囊变区域无强化。32例病变中，囊变者18例，伴分隔者16例，有血管者9例，伴出血者3例，钙化3例。除肿瘤形态对于诊断腹膜后异位嗜铬细胞瘤的良恶性有统计学意义外（P＝0．013），其余指标在诊断腹膜后异位嗜铬细胞瘤良恶性方面的差异均无统计学意义（均P＞0．05）。结论腹膜后异位嗜铬细胞瘤的CT和MR表现有一定的特征性，多为椎旁椭圆形肿物，沿椎旁长轴生长，强化明显，常伴囊性变，结合高血压及儿茶酚胺升高可做出诊断。
Objective To evaluate the CT and MR findings of retroperitoneal ectopic pheochromocytoma.Methods To analyze retrospectively the CT and MR images of 32 patients with retroperitoneal ectopic pheochromocytoma proved by pathology.Results The lesions （ benign =28, malignant=4） were located in the anterior pararenal space （ARS） （n=12）, the perirenal space （PS） （n=13） and the posterior pararenal space （PRS） （n=7）.The tumors showed heterogeneous density on unenhanced CT （n=25）.Among the 23 cases with enhanced CT imaging, 19 cases had marked contrast and 4 had mild contrast.The enhancement patterns included whole enhancement （ n =9 ） , solid area enhancement （ n=12 ） , peripheral enhancement （ n=1 ） , and spotted enhancement （ n=1 ） .The tumors had heterogeneous signal on unenhanced MR （n=23）, and usually showed enhancement at arterial, portal and delayed phases on 22 enhanced MR, while cystic area with no enhancement.The lesions usually had cystic changes （n=18）, septa （n=16）, vessels inside （n=9）, hemorrhage （n=3）, and calcification （n=3）.Besides that the morphology had statistical significance （P =0.013）, other indexes had no statistical significance （P〉0.05） in differential diagnosis of benign and malignant retroperitoneal ectopic pheochromocytomas.Conclusions Retroperitoneal ectopic pheochromocytomas have some CT and MR features, usually revealed as an oval mass, growing along the paravertebral axis, and often with cystic changes.Those signs combined with hypertension and elevated catecholamine level may lead to a correct diagnosis.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2015年第3期181-185,共5页
Chinese Journal of Oncology
关键词
腹膜后间隙
嗜铬细胞瘤
体层摄影术
X线计算机
磁共振波谱学
诊断
Retroperitoneal space
Ectopic pheochromocytoma
Tomography,X-ray computed
Magnetic resonance spectroscopy
Diagnosis
