腹膜后纤维化的CT诊断价值

目的探讨腹膜后纤维化(RPF)的CT表现及其诊断价值。方法回顾性分析经临床病理证实的6例RPF患者的CT资料,均行CT平扫后三期增强扫描以及图像后处理,其中4例还进行了CT尿路造影(CTU)。分析RPF病变位置、形态、边缘、密度及对周围器官的侵犯和增强后强化表现。结果 6例患者CT平扫均表现为腹膜后间隙近似于肌肉密度的不规则形软组织密度影;6例中5例表现为不规则软组织密度影呈弥漫性生长、并不同程度包绕腹膜后大血管;4例伴有输尿管受压致肾盂输尿管扩张积水、其中2例为双侧受压。增强扫描后5例病变有不同程度强化。结论多层螺旋CT及其图像后处理结合CTU检查能更全面地显示RPF的表现及侵犯范围,对本病的诊断和鉴别诊断具有重要价值,对临床治疗具有重要指导意义。

The Diagnostic Value of MSCT in Retroperitoneal Fibrosis

Objective To assess the value of MSCT in the diagnosis of the retroperitoneal fibrosis （RPF）.Methods Six patients of RPF proved clinical pathologically underwent CT plain and contrast enhancement scanning, and all the images were reconstructed with Coronal reconstruction, Sagittal reconstruction, Multiplanar reconstruction （MPR） and curved planar reformation （CPR）, including 4 cases also underwent CT urography （CTU）. Results CT plain scan showed homogeneous tissue isodensity to muscle and enveloping blood vessels in retroperitoneal space in 5 cases, as well as hydronephrosis and dilatation of the ureters in 4 cases,including 2 were bilateral. After contrast enhancement, lesions in 5 patients were enhanced differently.Conclusion MSCT and its reconstructions combining with CTU can show the manifestations of RPF and help the diagnosis and different diagnosis of RPF. It has important value in clinical application.