摘要
目的探讨腹膜后肿瘤及肿瘤样病变的CT与MRI影像特征及诊断价值。方法收集100例腹膜后肿瘤及肿瘤样病变患者的临床资料,均有明确的病理诊断结果,获取病理标本之前均进行CT、MRI检查,影像学图像完整清晰。结果 100例患者中,腹膜后良性病变者41例,以神经鞘瘤、节细胞瘤、神经纤维瘤、副节瘤等较为常见;腹膜后恶性肿瘤59例,以脂肪肉瘤、淋巴瘤、神经纤维肉瘤、精原细胞瘤等较为常见。术前CT、MRI诊断分别有5例、3例提示腹腔占位,其他均提示腹膜后间隙占位,肿瘤定位准确率分别为95. 00%、97. 00%。CT诊断腹膜后恶性肿瘤与良性病变的灵敏度、特异度、准确率分别为83. 05%、82. 93%、83. 00%,MRI分别为79. 66%、92. 68%、85. 00%,CT联合MRI分别为89. 83%、78. 04%、85. 00%,CT联合MRI的诊断效能更高。CT、MRI显示腹膜后良性病变体积较小,边缘规则、包膜完整、周围组织较少受推压,脂肪间隙存在,增强大多无强化;恶性肿瘤体积多较大,形态不规则,边缘模糊,以浸润性生长为主,可包绕大血管,内部易出现坏死、囊变及钙化,增强多明显强化。结论腹膜后肿瘤及肿瘤样病变的CT、MRI表现具有一定特征性,CT、MRI尤其是二者联合对病变的定位、定性诊断有重要价值。
Objective To investigate the CT and MRI imaging features and diagnostic value of retroperitoneal tumors and tumor-like lesions. Methods The clinical data of 100 patients with retroperitoneal tumors and tumor-like lesions were collected. All of them had clear pathological findings. CT and MRI examinations were performed before collecting pathological specimens,and images were complete and clear. Results Among the 100 patients,there were 41 patients with retroperitoneal benign lesions,and schwannomas,gangliocytomas,neurofibromas and paragangliomas were common. There were 59 patients with retroperitoneal malignant tumors,and liposarcomas,lymphomas,neurofibrosarcomas and seminomas were common. Preoperative CT and MRI diagnosed abdominal cavity occupancy in 5 and 3 cases,respectively. Others suggested retroperitoneal space occupancy. The accuracy rates of tumor location were 95. 00% and 97. 00%,respectively. The sensitivity,specificity and accuracy of CT in diagnosing retroperitoneal malignant tumors and benign lesions were 83. 05%,82. 93% and 83. 00%,respectively,while those of MRI were 79. 66%,92. 68% and 85. 00%,respectively. The sensitivity,specificity and accuracy of CT combined with MRI were89. 83%,78. 04% and 85. 00%,respectively. The diagnostic efficiency of CT combined with MRI was higher. CT and MRI showed that the retroperitoneal benign lesions were small,with regular margins,complete capsules,little pressure on surrounding tissues,fat gaps and without enhancement. Malignant tumors were large in size and irregular in shape,with blurred margins,invasive growth,encircling large blood vessels,with necrosis,cystic degeneration and calcification inside and obvious enhancement.Conclusion The CT and MRI features of retroperitoneal tumor and tumor-like lesions are different. CT and MRI,especially the combination of the two are of great value in the localization and qualitative diagnosis of lesions.
作者
陈前程
李莉
CHEN Qianc.hen;LI Li(Ezhou Steel Hospital,Ezhou,436000)
出处
《实用癌症杂志》
2019年第10期1673-1676,共4页
The Practical Journal of Cancer
基金
湖北省自然科学基金(编号:2017CFB147)
关键词
腹膜后肿瘤
肿瘤样病变
CT
MRI
影像特征
Retroperitoneal tumors
Tumor-like lesions
CT
MRI
Image characteristics
