腹部外周性原始神经外胚层肿瘤的CT及MR诊断

CT and MR diagnosis for abdominal peripheral primitive neuroectodermal tumor

目的研究分析CT与磁共振（MR）在诊断腹部外周性原始神经外胚层肿瘤中的应用价值。方法 60例腹部外周性原始神经外胚层肿瘤患者,在研究分析患者临床资料的基础上,患者均给予CT与MR扫描检查,观察检查结果。结果诊断结果显示,有32例患者的神经外胚层肿瘤出现于腹膜腔,16例患者肿瘤位于腹膜后间隙,另12例患者肿瘤分别位于左肾、右肾上腺与胰腺（各4例）;神经外胚层肿瘤位于胰腺部位的患者出现恶心、呕吐与黄疸等症状;在患者接受CT平扫时,影像学资料表现出不均匀的软组织肿块,且呈现出浸润性生长,与周围组织之间的界限并不是非常清晰,肿块直径3-15 cm,且平扫显示等密度或低密度;而在进行MR平扫时,发现T1WI出现等或低较为混杂的信号,肿瘤表现出的信号与肌肉相等或略低,而T2WI及抑脂像表现出不均匀的高信号或混杂信号,检查出的大部分肿瘤是不均匀的高信号,少数有出血征兆;在CT与MR增强扫描时,肿瘤表现出不均匀强化,且还会出现不同程度坏死的现象,并且还可观察到肿瘤出现隔样改变及网格状强化,在肿瘤靠近周围骨质时,就会发现相邻骨质被破坏,有的甚至可观察到骨膜反应。结论在诊断腹部外周性原始神经外胚层肿瘤时,利用CT与MR可充分显示肿瘤内部结构和相邻组织之间的关系,同时还能够观察到肿瘤转移情况,在临床中具有非常高的应用价值。

Objective To research and analyze application value of CT and magnetic resonance（MR） in diagnosis of abdominal peripheral primitive neuroectodermal tumor.Methods A total of 60 patients with abdominal peripheral primitive neuroectodermal tumor received CT and MR scan examination in addition to clinical data analysis,and their examination outcomes were observed.Results Diagnosis outcome showed 32 cases with neuroectodermal tumor in peritoneal cavity,16 cases in retroperitoneal space,12 cases respectively in left kidney,right adrenal and pancreas（4 cases with each type）.Neuroectodermal tumor in pancreas provided symptoms of nausea,vomiting and jaundice.CT plain scan imaging data showed uneven soft tissue mass with invasion growth and unclear boundary,diameter as 3~15 cm with equidensity or low density.MR plain scan showed T1 WI or lower mixed signals,with similar or lower tumor sign,while T2 WI and fat saturation showed uneven high or mixed signals.Major of detected tumors had uneven high signal,with few bleeding symptom.CT and MR enhancement scan showed uneven enhancement tumor signal,along with different degree of necrosis,diaphragm change and grid enhancement in tumor.Peripheral sclerotin was destroyed by nearby tumor,with some periosteal reaction.Conclusion Implement of CT and MR in diagnosing abdominal peripheral primitive neuroectodermal tumor can fully reveal relationship between inner structure and peripheral tissue,along with tumor metastasis.This method contains highly clinical application value.