MSCT在腹膜后副神经节瘤诊断中的应用价值
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摘要
目的探讨多层螺旋CT(MSCT)在腹膜后副神经节瘤诊断中的应用价值,提高对该病的认识。方法回顾性分析我院2003年5月~2012年4月经手术病理证实为腹膜后副神经节瘤的13例患者CT资料。所有患者均行MSCT增强扫描及三维后处理重建。以手术结果为标准,分析CT检查显示腹膜后副神经节瘤的准确性。结果 13例患者中,11例单发,2例多发,共计16个病灶。病灶均位于腹主动脉周围,呈椭圆形或圆形,平扫肿瘤呈等或略低密度,密度不均匀,2例病灶边缘钙化。增强扫描病灶不均匀明显强化,可见坏死和囊变区,7例瘤内或瘤周可见明显强化的迂曲血管影。CT增强扫描及三维重建在病灶大小、形态、位置、供血动脉及与周围组织关系的显示上与手术结果一致。结论腹膜后副神经节瘤的CT表现具有一定特异性,MSCT增强扫描及三维重建在腹膜后副神经节瘤的诊断中有重要价值。
Objective To discuss the diagnostic value of MSCT in retroperitoneal paraganglioma.Methods CT data of13patients in our hospital from May 2003to April 2012were retrospectively analyzed.All cases were diagnosed as retroperitoneal paraganglioma by pathological examination.CT contrast examination and three dimensional reconstructions were performed.Operative result was performed as a standard reference and the diagnostic accuracy of CT in retroperitoneal paraganglioma was investigated.Results Single tumor was found in 11patients and multiple tumors in 2patients.There were 16lesions.All lesions were located near the abdominal aorta.The tumors were oval or round.On plain CT,the lesions presented iso-or low density,and inhomogeneous density with necrosis,cystic configuration and calcification.On contrast-enhanced CT image,all tumors had inhomogeneous enhancement.The lesions of all patients showed intense enhancement after contrast.Intra-tumoral or peri-tumoral obviously enhanced dilated blood vessels were shown in 7patients.The location,size,characterization,feeding arteries and the relationship between the lesion and the neighboring tissue based on CT findings were consistent with intraoperative photography.Conclusion Retroperitoneal paraganglioma has specificity of CT findings.CT contrast examination and three dimensional reconstructions are of importance in diagnosis in retroperitoneal paraganglioma.
Objective To discuss the diagnostic value of MSCT in retroperitoneal paraganglioma.Methods CT data of13patients in our hospital from May 2003to April 2012were retrospectively analyzed.All cases were diagnosed as retroperitoneal paraganglioma by pathological examination.CT contrast examination and three dimensional reconstructions were performed.Operative result was performed as a standard reference and the diagnostic accuracy of CT in retroperitoneal paraganglioma was investigated.Results Single tumor was found in 11patients and multiple tumors in 2patients.There were 16lesions.All lesions were located near the abdominal aorta.The tumors were oval or round.On plain CT,the lesions presented iso-or low density,and inhomogeneous density with necrosis,cystic configuration and calcification.On contrast-enhanced CT image,all tumors had inhomogeneous enhancement.The lesions of all patients showed intense enhancement after contrast.Intra-tumoral or peri-tumoral obviously enhanced dilated blood vessels were shown in 7patients.The location,size,characterization,feeding arteries and the relationship between the lesion and the neighboring tissue based on CT findings were consistent with intraoperative photography.Conclusion Retroperitoneal paraganglioma has specificity of CT findings.CT contrast examination and three dimensional reconstructions are of importance in diagnosis in retroperitoneal paraganglioma.
引文
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[11]买赛虎,马庆久,王浩.腹膜后副神经节瘤的诊断与治疗[J].陕西医学杂志,2012,41(6):747-748.
[12]胡维维,王辉,陶金华,等.肾上腺外副神经节瘤临床病理分析[J].临床与实验病理学杂志,2010,26(1):77-80.
[2]Elder EE,Elder G,Larsson C.Pheochromocytoma and functional paraganglioma syndrome:no longer the 10%tumor[J].J Surg Oncol,2005,89(3):193-201.
[3]苗焕民,胡春洪,胡粟.原发性腹膜后副神经节瘤的CT诊断[J].中国血液流变学杂志,2012,22(2):336-338.
[4]林炳权,许乙凯,冯捷.腹膜后副神经节瘤CT诊断[J].放射学实践,2012,27(1):65-67.
[5]马永华,许守利,孙建刚,等.腹膜后肾上腺外副神经节瘤的CT、MRI表现[J].中国中西医结合影像学杂志,2011,9(2):126-128.
[6]张帅,余长亮,李仁民,等.腹膜后肾上腺外副神经节瘤的CT表现[J].中国介入影像与治疗学.2012,9(7):535-538.
[7]徐惊.膀胱副神经节瘤的CT诊断[J].医学影像学杂志.2013,23(1):103-106.
[8]石士奎.原发性腹膜后副神经节瘤的CT诊断与鉴别诊断[J].国际医学放射学杂志,2010,33(3):249-252.
[9]马霄虹,戴景蕊,张红梅,等.腹膜后副神经节瘤的临床及CT表现与病理对照研究[J].医学影像学杂志,2007,17(11):1225-1228.
[10]沈华,吴宏飞,周鹤同,等.原发性腹膜后副神经节瘤14例报告并文献复习[J].2011,26(10):777-779.
[11]买赛虎,马庆久,王浩.腹膜后副神经节瘤的诊断与治疗[J].陕西医学杂志,2012,41(6):747-748.
[12]胡维维,王辉,陶金华,等.肾上腺外副神经节瘤临床病理分析[J].临床与实验病理学杂志,2010,26(1):77-80.