腹膜后神经源性肿瘤的CT诊断

CT Diagnosis of Retroperitoneal Neurogenic Tumors

目的分析30例腹膜后神经源性肿瘤的CT表现,以加深对其认识。资料与方法30例均经病理证实。使用SiemensPlus4ACT扫描仪。全部病例均进行了CT平扫和增强扫描。结果(1)良性肿瘤16例,恶性肿瘤14例,位于肾上腺者19例,位于交感神经链上11例。(2)肿块不规则形14例,类圆形16例;边缘清楚25例,边缘模糊5例。(3)成神经细胞瘤和神经节成神经细胞瘤CT表现具有特征:平扫与肾脏呈等密度为主的混杂密度,增强扫描呈不均匀强化;均有较粗大无定形钙化伴有血管的包埋及腹膜后淋巴结肿大。其他病理类型的神经源性肿瘤CT表现的特征性没有前者明显。结论大多数腹膜后神经源性肿瘤可根据其CT表现、好发于肾上腺及沿椎旁交感神经链分布的特点,结合患者发病年龄和临床资料CT可作出诊断。

Objective To analyze the CT appearances of retropedtoneal neurogenic tumors in order to get a better understand- ing of the disease. Materials and Methods 30 cases with neurogenic tumors proved by pathology were examined by CT plain and contrast enhancement scanning preoperatively, Results （1） Of all cases, 14 cases were benign and 16 malignant. 19 cases were located in adrenal gland, 11 on the ganglion nerve chain. （2） The tumors were irregular in 14 cases and round in 16 cases. The tumor margin was distinct in 25 cases and indistinct in 5 cases. （3） neuroblastomas and ganglioneuroblastomas had characteristic CT appearances： masses were showed as mixed density and isodensity compared with the kidney on CT plain scan and en- hanced inhomogeneously with irregalar calcification, vascular encasements and lymph node enlargement. The CT appearances of the other retroperitoneal neurogenic tumors were less characteristic than the prevlous. Conclusion Most of retroperitoneal neurogenic tumors are diagnosed by CT according to their CT appearances and locations in adrenal glands and along paraspinal areas combined with the age of patients and clinic data.