腹膜后神经源性肿瘤 CT 征象与病理分类相关性分析

摘要

目的：分析腹膜后神经源性肿瘤的 CT 影像学征象与病理类型的相关性，提高对腹膜后神经源性肿瘤的影像学诊断和鉴别诊断。方法：对44例经手术、病理证实的腹膜后神经源性肿瘤的 CT 征象进行回顾性分析，并与手术后的病理结果进行对照、研究。结果：44例腹膜后神经源性肿瘤均位于从膈肌下至盆腔腹膜后间隙内。其中，良性36例，恶性8例；神经鞘瘤9例，神经纤维瘤9例，节细胞神经瘤17例，副神经节瘤5例，神经母细胞瘤4例；肿瘤生长在肝肾隐窝、脾肾隐窝及双侧肾上极区17例，腹主动脉及下腔静脉间或旁4例，肾前间隙及肾内缘12例，双侧腰大肌前缘及前外侧7例，骶骨前缘及盆腔内2例，其它部位2例；肿瘤外形呈圆形或类圆形30例，不规则形14例。结论：腹膜后神经源性肿瘤的 CT 征象有其一定的特征性，通过对病理类型与肿瘤 CT 征象的关系分析，能提高 CT 检查对腹膜后神经源性肿瘤的诊断并在临床有较好的应用。%Objective:To study CT imaging manifestations and pathological classification of 44 cases of retroperito-neal neurogenic tumors. Methods:All 44 cases of retroperitoneal tumors were located under the diaphragm and the pelvic retroperitoneal space. Results:In 44 cases,there were benign 36 cases,8 cases of malignant. There were nerve sheath tumor 9 cases,nerve fibroma 9 cases,ganglion cells neuroma 17 cases,paraganglioma in 5 cases,4 cases of neuroblastoma. Tumor growth in liver and kidney fossae,the upper pole of the spleen and kidney fossae and bilateral renal area 17 cases,abdominal aorta and inferior vena cava or near 4 cases,renal clearance before and 12 cases,bilat-eral psoas major front and anterolateral 7 cases,leading edge of the sacrum and pelvic cavity in 2 cases,other parts 2 cases. Tumor shape was round or class round 30 cases,14 cases of irregular shape. There were 6 cases present ″sha-ping″ growth,5 cases of visible ″tail sign″. The density of tumor in 12 cases was solid,solid capsule in 16 cases,16 cases of cystic. Enhanced scan:There were 25 cases visible and delay of mild or moderate arterial enhancement,17 cases of tumor did not see improved or only wall slightly improved. Conclusion:CT signs of retroperitoneal neurogenic tumor has its characteristic,through the analysis on the relationship between the pathological classification and tumor CT signs,to improve the CT examination in the diagnosis of retroperitoneal neurogenic tumors.