腹膜后脂肪肉瘤的CT表现和病理对照分析

目的:分析腹膜后脂肪肉瘤的CT表现和病理的相关性,总结其CT特点,提高正确诊断率。方法:手术或穿刺病理证实的腹膜后脂肪肉瘤23例,结合病理,回顾性分析CT征象。结果:各病理类型脂肪肉瘤的CT表现特点:脂肪瘤样脂肪肉瘤(LLS)表现为巨型脂肪密度肿块,有网状分隔和实性结节,分隔和结节轻度强化。硬化型脂肪肉瘤(SLS)多为无脂肪成分的混杂密度肿块,可见钙化,增强延迟后实性部分强化更明显。黏液型脂肪肉瘤(MLS)多为液性密度肿块,增强后假包膜明显强化。圆形细胞肉瘤(RCLS)和多形性脂肪肉瘤(PLS)均为肌肉样密度肿块,圆形细胞型中央有大片低密度坏死灶,明显不均匀强化;多形性肿瘤密度均匀,境界清楚,多为均匀强化。去分化型脂肪肉瘤(DDLS)为脂肪密度与软组织密度混杂肿块,两种密度分界清楚。混合型脂肪肉瘤为肿块内有上述类型脂肪肉瘤组织表现。结论:腹膜后脂肪肉瘤成分复杂,不同组织学类型的脂肪肉瘤在不同病理分化阶段有不同CT表现,认识其CT表现特点有利于提高诊断准确性。

Objective ：To analyse the retroperitoneal liposarcoma of CT manifestations and pathologic correlation, summarizes its characteristics, improve the correct diagnostic CT. Methods：surgery or puncture pathology of retroperitoneal liposarcoma 23 cases were analyzed retrospectively, pathology, CT signs. Results：the pathologic types liposarcoma CT performance characteristics： lipoma （LLS） sample liposarcoma is fat mass density, giant separation and solid nodules mesh, space and nodules. Mild Sclerosis （SIS） type liposarcoma of the mass density of mixed fat content, calcification, after a solid aggrandizement is more obvious. Myxoid liposarcoma type （MLS） for liquid mass density, enhance sexual obviously after psuedocapsule. Round cell sarcoma （ RCLS ） and pleomorphic liposarcoma （PIS） are muscle mass density,round cell sample of low density type central necrosis, obvious uneven aggrandizement, Pleomorphic tumor density, state clearly, as well. To DDLS （differentiation type liposarcoma is adipose density and soft tissue ） mixed bump,two density density border. Mixed liposarcoma is in these types of fat mass organization performance sarcoma. Conclusion ： retroperitoneal liposarcoma complicated composition, different histological types in different pathological liposarcoma have different CT differentiation stage, the performance characteristic CT is helpful to improve the diagnosis accuracy.