盆部原发肿瘤CT表现特征及其解剖学基础

目的分析盆部原发肿瘤CT增强表现特征，探讨产生各种影像表现的病理学和解剖学基础。方法回顾性分析14例经病理学证实的盆部原发肿瘤CT增强表现，包括病灶大小、密度、边缘、强化特征，肿块所在的解剖部位及其与邻近组织器官和间隙的关系等。结果良性肿瘤3例，恶性肿瘤11例。肿块位于盆腹膜腔和腹膜外间隙各6例，盆腹膜腔和腹膜外间隙同时受累2例。CT增强表现为实质性8例，囊实性6例；均匀强化3例，不均匀强化11例。肿块周围脂肪间隙清晰和受侵犯各7例。4例病灶内出现钙化，其中良性畸胎瘤2例，恶性畸胎瘤和类癌各1例。结论CT增强扫描能准确判断盆部原发肿瘤的解剖位置及其与邻近解剖结构的毗邻关系，初步判断肿瘤的良恶性，对畸胎瘤能做出比较明确的定性诊断。

CT characteristics of extra-organic primary tumor in pelvis and the anatomic bases

Objective To analyze the CT contrast enhanced features of the extra-organic primary tumors in pelvis and to evaluate anatomic bases of these imaging characteristics.Methods CT findings in 14 patients with pathologically proved extra-organic primary tumors in pelvis were reviewed retrospectively for tumor size,density,margins,contrast enhanced characteristics,location and relationship of the lesions with surrounding organs and tissues.Results There were benign tumors (n=3) and malignant tumors(n=11) in this study.There were 6 lesions in peritoneal cavity and 6 in retroperitoneal space of pelvis respectively,and two other masses were in both peritoneal cavity and retroperitoneal space of pelvis.CT scan revealed that there were 6 solid masses and 8 cystic-solid masses.The enhanced characteristics of lesions were homogeneous and heterogeneous in 3 and 11 patients respectively.The fatty space surrounding the lesion was invasive in 7 cases and all of them were malignant tumor.The fatty space surrounding lesion was clear in other 7 cases including 3 benign tumors and 4 malignant tumors.CT revealed calcification in 4 lesions including benign teratoma (n=2) , malignant teratoma (n=1), and carcinoid (n=1).Conclusion In the diagnosis of extra-organic primary tumors in pelvis,CT enhancement scan can reveal the anatomic location and relationships of the lesions with surrounding organs and tissues and can differentiate benign and malignant tumor to some degree.