Gardner综合征的腹部CT表现

Abdominal CT Findings of Gardner Syndrome

目的探讨Gardner综合征的腹部CT表现和诊断价值。资料与方法收集6例经临床病理确诊的Gardner综合征患者的腹部CT资料,回顾性分析其肿瘤发病部位、数量、大小、形态、边界、密度、与周围组织的关系及增强扫描特征,并探讨CT征象在Gardner综合征鉴别诊断中的价值。结果 6例Gardner综合征患者中,5例表现为腹部实性肿块,1例表现为囊实性肿块;2例位于肠系膜,3例位于肠系膜、腹膜后间隙,1例肠系膜、腹壁及腹膜后间隙均可见肿块,5例CT定位正确;1例呈椭圆形,边缘光滑,边界清晰;所有病灶体积均较大,最大者约12.8cm×15.0cm×17.7cm;所有病灶密度不均匀,3例中心可见较大范围囊变坏死,未见明显出血及钙化;所有病灶均不同程度地推压周围组织器官移位、变形,2例侵犯十二指肠。CT增强扫描4例呈轻度渐进性强化,2例未见明显强化。结论 Gardner综合征的诊断依靠临床和病理检查,CT可准确定位腹腔内或腹壁硬纤维瘤。明确肿瘤的特征、范围及其与周围组织的关系可更加全面地反映患者的病情,并指导治疗。

Purpose To explore abdominal CT findings and diagnostic value of Gardner syndrome. Materials and Methods The abdominal CT data of 6 patients definitely diagnosed with Gardner syndrome via clinical pathology were collected. The location, number, size, shape, boundary, density, relationship with surrounding tissues and enhanced scanning characteristics of the tumor were retrospectively analyzed, and the value of CT signs in differential diagnosis of Gardner syndrome was also explored. Results Of the 6 patients with Gardner syndrome, 5 showed solid abdominal mass, and 1 cystic solid mass; 2 were in mesentery, 3 in mesenteric and retroperitoneal space, and 1 in mesentery, abdominal wall and retroperitoneal space with masses visible. 5 cases were found correct CT positioning; 1 case was oval-shaped, with smooth edges and clear borders; all lesions bear large volumes, the largest of which was about 12.8 cm× 15.0 cm× 17.7 cm; all lesions displayed uneven density, with 3 cases demonstrating extensive cystic necrosis visible in the center and no obvious hemorrhage and calcification spotted; all lesions pushed the displacement and deformation of surrounding tissues and organs in varying degrees, and 2 cases was found invasions in duodenum. 4 cases showed mild progressive enhancement under enhanced scanning, with 2 cases suggesting no obvious enhancement. Conclusion The diagnosis of Gardner syndrome rests upon clinical and pathological findings. CT serves to accurately locate intraperitoneal or abdominal wall desmoid, and define tumor features, range and its relations with surrounding tissues in an attempt to fully reflect patients＇ condition and guide treatment.