腹膜后脂肪肉瘤:螺旋CT动态增强的表现

Retroperitoneal Liposarcoma:CT -Pathologic Correlation

目的：分析腹膜后脂肪肉瘤的CT表现及其血液动力学特征,以提高其诊断准确性。方法：经手术病理证实的腹膜后脂肪肉瘤13例,术前经螺旋CT或多排螺旋CT平扫、动脉期和门脉期扫描,注射流率3ml/s。复习CT扫描结果并和手术病理作回顾性对照分析。结果：13例脂肪肉瘤中脂肪瘤样脂肪肉瘤5例,硬化型2例,黏液型3例,去分化型2例,混合型1例。肿瘤形态不规则9例,规则4例。直径11.3-29.7cm,平均14.9cm。不同类型肿瘤和同一肿瘤不同区域密度多样。肿瘤实质成分动脉期轻度至中度强化,内可见肿瘤血管;门脉期强化程度有所增加,不同类型肿瘤和同一肿瘤不同区域强化程度和强化方式多样。结论：腹膜后脂肪肉瘤境界不清,跨腹膜后器官间隙生长,成分复杂,动态增强为进行性延迟强化。认识脂肪肉瘤的各种表现有助于提高诊断率。

Objective： To correlate the CT and pathologic findings of retroperitoneal liposarcoma. Methods：the CT and pathologic findings of 13 cases of retroperitoneal liposarcoma were reviewed retrospectively, including lipoma-like （n=5）, sclerosing （n= 2）, myxoid （n= 3）, dedifferentiated （n= 2） and mixed liposarcoma （n= 1 ）, Spiral CT was performed before and after injection of contrast material. Results： The mean diameter of the 13 lesions was 14.9cm （range 11.3 to 29.7cm）. Nine were irregularly margined. Various densities were presented in tumors of various pathologic type or various areas in a tumor. Mild to moderate enhancement and tumor angiogenesis were demonstrated in solid components of the tumors on arterial phase and increased enhancement were noted on port venous phase. Different degrees and patterns of enhancement were presented in tumors of various pathologic type or various areas in a tumor. Conclusion： Retroperitoneal liposarcoma typically presents as a large, irregular margined mass with heterogeneous density and progressive heterogeneous delayed contrast enhancement.