原发性腹膜后脂肪肉瘤的CT诊断

CT Diagnosis of Primary Retroperitoneal Liposarcomas

目的探讨原发性腹膜后脂肪肉瘤的CT表现及鉴别诊断要点。资料与方法回顾性分析经手术病理证实的20例原发性腹膜后脂肪肉瘤的CT资料。20例均行CT平扫,19例行增强扫描。结果(1)肿瘤大小约10cm×14cm×16cm^15cm×17cm×30cm;肿瘤的形态绝大多数不规则。所有肿瘤均位于腹膜后间隙。(2)20例脂肪肉瘤中,17例肿块中含有典型的脂肪成分,其CT值为-20^-130HU,增强扫描时肿块内的脂肪成分无强化,软组织成分轻度强化,其中1例伴有钙化;1例肿瘤的上部呈软组织密度,下部呈囊性改变;另2例为黏液型脂肪肉瘤,平扫CT值为20HU,1例增强无强化,另1例未行增强扫描。结论CT在原发性腹膜后脂肪肉瘤的定位诊断以及判断肿瘤与邻近器官的关系方面具有十分重要的价值,而且对分化型脂肪肉瘤或含脂肪的其他类型脂肪肉瘤能够明确诊断。

Objective To discuss CT appearances of primary retroperitoneal liposarcoma and the differentiated points. Materials and Methods The CT findings of 20 cases with primary retroperitoneal liposarcoma proved by operation and pathology were analyzed retrospectively. 20 cases were examined by CT plain scanning and 19 by contrast enhancement scanning preoperatively. Results The size of 20 liposarcomas was ranged from 10cm×14cm×16cm to 15cm×17cm×30cm. The shape of liposarcoma was irregular. All tumors were located in the retroperitoneal space. Of 20 liposarcomas, 17 cases had huge heterogeneous masses with fat attenuation, On CT contrast, the fat was not enhanced, the soft-tissue component was slightly enhanced, 1 ease with calcification. 1 case with liposareoma had cyst element. The other two cases were myxoid liposarcomas without enhancement. Conclusion CT plays an important role in the precise localization of primary rctroperitoneal liposarcomas, also in determination of the extent of invasion and characterization of the some specific pathologic type such as well-differentiated liposarcomas, myxoid liposarcomas and dcdifferentiated liposareomas.