螺旋CT在原发性腹膜后占位性病变鉴别诊断中的应用价值

Application value of spiral CT in differential diagnosis of primary retroperitoneal space occupying lesions

目的 探讨螺旋CT在原发性腹膜后占位性病变鉴别诊断中的应用价值。方法回顾性分析2012年6月~2016年6月50例原发性腹膜后占位性病变患者应用螺旋CT的定性、定位诊断准确率。结果(1)病理诊断:良性20例,恶性30例,主要类型来源:间叶组织来源(n=28)、神经组织来源(n=14)、淋巴组织来源(n=5)、生殖细胞来源(n=3);(2)组织学类型主要包括:平滑肌瘤、脂肪瘤、淋巴组织瘤、脊神经鞘细胞瘤、神经节细胞瘤、副神经节细胞瘤、淋巴瘤、生殖细胞瘤、粒细胞瘤等类型,经CT扫查,除生殖细胞瘤边界不清楚外,其他类型肿瘤边界均清楚;平滑肌瘤、脂肪瘤及脊神经鞘细胞瘤均分别有1例为量变,平滑肌瘤、脂肪瘤及淋巴组织瘤钙化/骨化例数分别为2例、1例及2例,平滑肌瘤、脂肪瘤及淋巴组织瘤坏死例数分别为4例、3例及2例;(3)50例患者中,螺旋CT定位准确例数为41例,定位准确率为82.00%(41/50);定性准确例数为32例,定性准确率为64.00%(32/50)。结论螺旋CT在原发性腹膜后占位性病变鉴别诊断中具有一定的价值,在对疾病的定性与定位诊断过程中具有一定的优势。

Objective To investigate the value of spiral CT in differential diagnosis of primary retroperitoneal space oc- cupying lesions. Methods A retrospective analysis of 50 cases primary retroperitoneal lesions in patients with clinical data from June 2012 to June 2016 was performed to determine the accuracy of the localization and diagnosis of spiral CT. Results （1）by pathological diagnosis, benign patients were 20 cases, malignant patients were 30 cases, there were mainly 4 types of sources,included the source of mesenchymal tissue（n=28） and nerve tissue source（n=14）, lymphoid tissue （n=5） and germ cells（n=3） sources; （2）Hist01ogical types included： lipoma, leiomyoma, lymphoid tissue tumor, spiIlal nerve sheath tumor cells, ganglion cell tumor, paraganglioma, lymphoma and germ cell tumor, granular cell tumor types, by CT scanning, in addition to germ cell tumor boundary were not clear, other types of tumor boundary were clear; leiomyoma, lipoma and spinal nerve sheath tumor were 1 case for the quantitative, leiomyoma, lipoma and lymphoid tis- sue tumor calcification/ossification were 2 eases, 1 case and 2 cases, leiomyoma, lipoma and lymphoid tissue tumor necrosis were 4 cases, 3 cases and 2 cases; （3）Among 50 patients, accurate positioning of spiral CT for 41 cases, the accurate rate of localization was 82.00%（41/50）; the number of cases for the qualitative accuracy in 32 cases, the ac- curacy of qualitative diagnosis was 64.00% （32/50）. Conclusion Spiral CT is of certain value in differential diagnosis of primary retroperitoneal space occupying lesions,it has some advantages in the qualitative and location diagnosis of the disease.