螺旋CT动态增强扫描在脂肪肉瘤诊断中的应用

目的分析脂肪肉瘤螺旋CT动态增强扫描的影像表现,提高对脂肪肉瘤的认识水平。方法分析2008年7月至2014年2月由广西医科大第一、第四附属医院诊治并经手术病理证实的脂肪肉瘤病例28例,联系临床资料、病理结果,总结脂肪肉瘤CT动态增强扫描的影像特征。结果 28例脂肪肉瘤,CT检查肿瘤内脂肪成分的总检出率为71%(20/28,71%),其中硬化型、粘液型脂肪肉瘤CT检查肿瘤内脂肪成分的检出率较低(分别为:0/2,0%;5/10,50%)。粘液型脂肪肉瘤CT平扫均可见CT值0-20HU的"粘液成分"(10/10,100%)。CT动态增强扫描肿瘤内测量区、周围正常组织均有延迟强化趋势(总体P0.05,且各期两两比较P0.05),但肿瘤内测量区的强化更明显;单独分析粘液型脂肪肉瘤,有延迟强化趋势(总体P0.05),各期两两比较,平扫与动脉期CT值之间无统计学差异(P0.05),平扫与静脉期、动脉期与静脉期CT值之间均有差异(均P0.05)。结论部分亚型脂肪肉瘤CT检查脂肪成分少见,一些粘液型脂肪肉瘤平扫表现为良性囊肿,动态增强扫描延迟强化对诊断有帮助。

The Application of Dynamic Enhanced Spiral CT in the Diagnosis of Liposarcoma

Objective Imaging Features of Liposarcoma on Dynamic Contrast-enhanced Spiral CT were analysed retrospectively to raise the level of imaging diagnosis. Methods 28 cases of liposarcoma confirmed by pathology from July, 2008 to February, 2014 at the first and fourth affiliated hospital of Guangxi medical university were analyzed retrospectivly. The imaging features of liposarcoma on dynamic contrast-enhanced spiral CT were studied together with the clinical data and pathological results. Results 28 cases of liposarcoma, the total detection rate of fat component in the tumors on CT is 71%(20/28, 71%), the detection rate in the sclerosing liposarcoma and myxoid liposarcoma are lower than the another subtypes (respectively as follows: 0/2, 0%, 5/10, 50%). The CT value of "mucus component" is 0-20HU, and the "mucus component" was seen in all myxoid liposarcoma (10/10, 100%). Dynamic contrast-enhanced CT: both the measuring areas within the tumors and the surrounding normal tissues were seen delayed enhancement trend (totality P<0.05, and each phase pairwise comparisons both P<0.05), but the degree of the enhancement within the tumors was more obvious; a separate analysis of myxoid liposarcoma, the measuring areas within the tumors were seen delayed enhancement trend (totality P<0.05), but there was no statistical difference between the routine scan and the arterial phase(P>0.05), there were statistical differences between the routine scan and venous phase, arterial phase and venous phase (both P<0.05). Conclusion The fat component of some subtypes of liposarcoma is rare on CT, some myxoid liposarcomas appear to be cystic at nonenhanced CT imaging, dynamic enhanced CT can help diagnosis.