腹盆部非固有脏器恶性软组织肿瘤的CT和MRI征象分析

CT and MRI Findings of Malignant Soft Tissue Tumors of Non-intrinsic Organs in Abdomen and Pelvis

目的为了提升腹盆部非固有脏器恶性软组织肿瘤影像诊断能力,分析腹盆部非固有脏器恶性软组织肿瘤的CT和MRI特征。方法收集17例经病理确诊的腹盆部非固有脏器恶性软组织肿瘤,行CT三期增强+MRI平扫及常规增强者1例、CT三期增强者13例、CT直接增强+MRI平扫及常规增强者1例、CT直接增强2例。结果去分化脂肪肉瘤2例,高分化脂肪肉瘤1例,黏液样脂肪肉瘤1例,高危险度胃肠道外间质瘤6例,平滑肌肉瘤复发1例,血管肉瘤1例,滑膜肉瘤1例,骨外尤文肉瘤1例,未分化多形性肉瘤(即所谓的恶性纤维组织细胞瘤)1例,恶性孤立性纤维性肿瘤1例,胚胎型横纹肌肉瘤1例。位于腹膜后3例,腹腔9例,盆腔5例。年龄26岁~71岁,肿瘤最大径63.5mm~238.7mm,男性10例,女性7例。结论脂肪肉瘤、平滑肌肉瘤和胃肠道间质瘤是最常见的腹盆部恶性软组织肿瘤,不含脂肪组织的恶性软组织肿瘤影像学表现具有相似性,但仍各具特点,了解腹盆部恶性软组织肿瘤谱及其影像学表现,对提升诊断能力具有重要意义。

Objective To analyze the CT and MRI features of malignant soft tissue tumors of non-intrinsic organs in the abdomen and pelvis.Methods A total of 11 cases of malignant soft tissue tumors of abdominal and pelvic non-intrinsic organs confirmed by pathology were collected.One case underwent threestage CT enhancement+MRI plain and conventional enhancement,thirteen cases underwent threestage CT enhancement,one case underwent CT direct enhancement+MRI plain and conventional enhancement,and two cases underwent CT direct enhancement.Results 2 case was dedifferentiated liposarcoma,1 case was well differentiated liposarcoma,1 case was myxoid liposarcoma,6 cases were high risk grade extra-gastrointestinal stromal tumors(EGIST),1 case was leiomyosarcoma,1 case was angiosarcoma,1 case was synovial sarcoma,1 case was extraskeletal Ewing sarcoma,1 case was undifferentiated pleomorphic sarcoma(so-called malignant fibrous histiocytoma),1 case was malignant solitary fibrous tumor,and 1 case was embryonal rhabdomyosarcoma.3 cases were located in retroperitoneal cavity,9 cases in abdominal cavity and 5 cases in pelvic cavity.The patients ranged from 26 to 71 years old,with a maximum diameter of 63.5mm to 238.7mm.There were 10 males and 7 females.Conclusion Liposarcoma,leiomyosarcoma and EGIST are the most common malignant soft tissue tumors in the abdomen and pelvis.The imaging manifestations of malignant soft tissue tumors without adipose tissue are similar,but still have some characteristics.To understand the spectrum and imaging manifestations of malignant soft tissue tumors in the abdomen and pelvis is of great significance to improve the diagnostic ability.