腹膜后纤维化的CT及MRI影像学分析

目的探讨腹膜后特发性纤维化的CT及MRI影像学表现和诊断。方法回顾性分析经手术病理证实的7例腹膜后纤维化患者的CT及MRI影像检查资料,男5例,女2例,将两种检查结果进行分析。结果 7例腹膜后纤维化患者在CT上均表现为后腹膜腹主动脉周围不规则肿块,呈轻中度强化,伴有周围组织的包埋,一侧或双侧输尿管上段扩张,肾积水。在MRI上表现为腹膜后纤维化早期病灶呈稍长T1稍长T2信号,中度强化;腹膜后纤维化晚期呈稍长T1稍短T2信号,延迟期轻度强化。结论腹膜后特发性纤维化起病隐匿,早期临床表现无特征性,CT及MRI检查对腹膜特发性纤维化具有重要的诊断价值,腹膜后出现弥漫或肿块样病变合并肾及输尿管积水可作为诊断腹膜后特发性纤维化的依据。

Analysis of CT and MRI on diagnosis of retroperitoneal fibrosis

Objective To evaluate the diagnostic value and describe CT,MRI findings in retroperitoneal fibrosis.Methods A retrospective analysis was made to analyze the spiral CT images in 7 cases(6 males,2 females) of pathologically confirmed retroperitoneal fibrosis,and the results were compared with MRI.Results Retroperitoneal fibrosis showed similar features in CT imaging:retroperitoneal irregular mass around abdominal aorta embedding adjacent tissue,with mild or moderate enhancement,unilateral or bilateral ureterectasis and hydronephrosis.MRI showed slightly low signal on T1WI and slightly high signal on T2WI in earlier period mass,midrange enhancement.In advanced stage,all slightly low signal was showed,slight enhancement on delayed phase.Conclusions The pristine clinical manifestation of retroperitoneal fibrosis is occult and nonspecific.CT and MRI examination is avaluable approach to diagnose retroperitoneal fibrosis.Diffuse plaque or masses in retroperitoneal space accompanied with hydronephrosis or dilatation of the ureters suggest the diagnosis of retroperitoneal fibrosis(RPF).