腹膜后肿瘤的CT/MRI影像学诊断

目的:探讨腹膜后肿瘤的CT/MRI影像学特点与病理表现的关系,提高腹膜后肿瘤诊断及鉴别诊断水平。方法:回顾分析我院2006年3月～2011年10月经手术病理确诊的31例腹膜后肿瘤的CT/MRI表现,并与临床资料及病理检查结果进行对比分析。结果:31例术前CT/MRI检查均显示腹膜后占位性病变,病理示良性13例,恶性18例。按组织起源分类,其中间叶组织肿瘤13例(脂肪肉瘤6例、脂肪瘤3例、平滑肌肉瘤1例、平滑肌瘤2例、恶性纤维组织细胞瘤1例);神经源性肿瘤9例(神经鞘瘤5例、恶性神经鞘瘤1例、副神经节瘤3例);胚胎残余组织肿瘤(精原细胞瘤)1例;淋巴瘤8例。CT/MRI定位诊断正确率93.5%(29/31),组织学类型诊断正确率58.1%(18/31)。CT/MRI可比较直观地显示肿瘤的大小、形态及周围组织情况,并可进行肿瘤部分成分的分析。结论:CT/MRI影像学表现及部分成分分析,对腹膜后肿瘤的诊断有重要价值。

Diagnostic value of CT/MRI in retroperitoneal tumor

Objective:To examine the features of retroperitoneal neoplasms on CT/MRI imaging and characterization of the specific pathologic type for improving the diagnosis and differential diagnosis of this tumor.Methods:Between Mar.2006 and Oct.2011,31 patients confirmed surgically and pathologically as retroperitoneal tumors were reviewed regarding CT/MRI characteristics and compared with their clinical data and pathologic findings.Results:Totally,preoperative examination by CT and/or MRI exhibited occupying lesions in retroperitoneal space,in which 13 were benign cases and 18,malignant.By the origin and histological classification,13 cases were originated from mesenchymal tissue(including 6 cases of liposarcoma,3 lipomas,1 leiomyosareoma,2 leiomyomas and 1 malignant fibrous histocytoma)and 9 arose from neurogenic tissue(5 cases of Schwannoma,1 malignant Schwannoma and 3 paragangliomas).One case was embryonic residual tumor(spermatocytoma) and another 8,lymphomas.The accurate diagnosis by CT/MRI localization was 93.5%(29/31) compared to 58.1%(18/31)by histological confirmation.Still,CT/MRI were capable of demonstrating the tumor size,shape and surrounding tissues besides partial reference to the tumor components.Conclusion:CT/MRI imaging with characterizing the partial components of the neoplasm will make sound diagnosis and differentiation of retroperitoneal tumors.