多层螺旋CT对腹膜后纤维化的诊断价值

The diagnostic value of MSCT in retroperitoneal fibrosis

目的探讨腹膜后纤维化(RPF)的多层螺旋CT(MSCT)影像学表现。方法对11例经手术及穿刺活检病理证实的RPF患者的MSCT图像资料进行回顾性分析,11例患者2例行平扫,9例行增强扫描。结果腹膜后纤维化的MSCT表现为腹膜后类圆形或不规则形软组织影,包绕腹膜后大血管或输尿管。11例中2例为软组织肿块型,9例为弥漫型,11例均包绕后腹膜大血管或输尿管,6例有单侧或双侧肾积水。CT平扫为腹膜后软组织影,密度较均匀或不均匀,近似肌肉密度,增强扫描病灶呈轻-中度强化。采用多平面重建(MPR)技术进行后处理可进一步明确病变与周围组织的关系。结论 MSCT检查有利于明确病变的大小、范围、部位、形态、密度及强化特征,对RPF的诊断和随访有重要价值。

Objective To discuss MSCT findings of retroperitoneal fibrosis （RPF）. Methods MSCT findings and clinical data of 11 cases （2 cases with CT plan scan and 9 cases enhancement scan） of RPF confirmed by pathology with surgery and biopsy were retrospectively analyzed. Results MSCT manifestations included circular or irregular mass at retroperitoneum, and the neighboring enveloped large blood vessel and ureter. 2 cases showed mass type at retroperitoneum, 11 cases showed large blood vessel and ureter was enveloped and 6 cases showed unilateral or bilateral ureterectasis. Non-contrast MSCT scan revealed soft tissue mass at retroperitoneum with inhomogenous or homogenous isodensity to muscle. After contrast-medium injection, the lesions were enhanced with light-moderate extent. It was useful to further clarify the relationship between the lesions and surrounding tissues by MPR. Conclusion MSCT scans have great value for clinic diagnosis and follow-up by providing information including range, location, shape, density, and enhanced characteristic.