腹膜后副神经节瘤的临床及CT表现与病理对照研究

目的:探讨腹膜后副神经节瘤的临床表现及CT诊断价值。方法:回顾性分析有完整病历及CT资料、经手术病理证实的腹膜后副神经节瘤27例,将临床及CT表现与病理学结果进行对照分析。结果:临床表现:有高血压症状10例,无高血压症状但术中出现血压波动6例,无高血压及术中血压波动11例。CT表现:肿瘤多位于腹中线大血管周围(19个病灶),并多大于5cm(21个病灶),增强CT表现为实性、明显强化,常伴有囊变或坏死。临床表现与病理对照:嗜铬性副神经节瘤16例,有高血压症状10例,另外6例术中有血压波动;非嗜铬性副神经节瘤11例,无任何症状6例,腹部包块4例,血尿1例。CT表现与病理对照:良性肿瘤边缘光整,病灶内囊变区内壁光整,边界清楚;恶性肿瘤形态不规则,"囊变区"不规则,边界不清楚。CT诊断正确率为88.9%,误诊11.1%。结论:临床症状结合增强CT表现在术前对大多数腹膜后副神经节瘤能做出正确诊断。

Retroperitoneal paraganglioma: clinical features and CT findings with pathologic correlation

Objective:To investigate the clinical features and the value of CT in diagnosing retroperitoneal paraganglioma.Methods:CT scan was performed in 27 patients.Clinical information and CT findings of 27 cases(28 lesions) with pathologically-proved retroperitoneal paraganglioma were retrospectively analyzed.Results:The clinical features included hypertension(10 casses),hypertension during operation(6 cases).The remaining 11 cases had no hypertension in any case. The tumors were located in the abdominal major vessels(19 lesions).21 of 28 lesions were more than 5 cm in diameter.Most of the masses were solid and richly vascularized.Usually,the tumor showed strong enhancement.Necrosis and cystic degeneration were common findings.10 of 16 pheochromocytic paraganglioma had hypertension.The other 6 cases had hypertension during operation.The clinical manifestation of non-pheochromocytic paraganglioma included abdominal masses(4 cases),hematuria(1 cases),no clinical symptoms(6 cases).The benign lesions appeared as well-circuscribed,cystic degeneration wall of them were smooth and sharply margin.The malignant lesions had irregular margins,indistinct border,"cystic degeneration wall" of them were irregular and indistinctly margin.The accuracy of CT diagnosis was 88.9%.Then 11.1% of the cases was made a wrong diagnosis.Conclusion:A combination of CT findings with clinical information can usually provide correct diagnosis to the most of cases before operation.