腹膜后纤维化的CT特征及误诊原因分析

 目的　评价CT在腹膜后纤维化诊断中的价值，并分析误诊原因。方法　回顾性分析经临床病理证实的10例腹膜后纤维化患者的CT资料，所有患者均接受CT平扫及增强扫描，分别由2名高年资医师采用盲法对腹膜后纤维化病变位置、边界、密度以及对周围组织的侵犯和强化情况进行评价。结果　所有患者CT平扫表现为腹膜后近似于肌肉密度的不规则形软组织病变，6例包绕腹膜后大血管，2例伴有肾盂输尿管扩张积液。增强扫描示9例病变不同程度强化，1例无明显强化。10例患者中有6例分别被误诊为腹膜后神经鞘瘤或淋巴瘤等。结论　CT可显示腹膜后纤维化的特征，综合分析各种影像学检查结果有助于腹膜后纤维化的诊断。误诊原因主要是由于腹膜后纤维化为少见疾病，日常工作中对该病的影像学表现认识不足。

CT features and misdiagnosis analysis of retroperitoneal fibrosis

Objective To assess the value of CT in the diagnosis of PRF, and analyze the reason of misdiagnosis. Methods Retrospectively analyze the CT data of ten patients with retroperitoneal fibrosis, which were confirmed by the clinical pathology. All the patients underwent CT scan and enhanced scan. Two experienced physicians using the blind method to evaluate the location, boundary, density, invasion on the surrounding tissue and enhancement of retroperitoneal fibrosis lesions respectively. Results All patients with CT scan findings were retroperitoneal irregular-shaped soft tissue lesions, which was similar to muscle density. 6 cases with surrounding the retroperitoneal vessel, 2 cases with expansion and hydrops of renal pelvis and ureter.By enhanced scan, 9 cases with different degrees of enhancement, 1 case without obvious enhancement. 6 cases were misdiagnosed as retroperitoneal schwannoma or lymphoma. Conclusion CT can show the characteristics of retroperitoneal fibrosis. Comprehensively analyze various imaging findings is helpful for the diagnosis of retroperitoneal fibrosis. Misdiagnosis reason is mainly due to retroperitoneal fibrosis is a rare disease, and understanding of this disease in imaging findings is insufficient in the daily work.