腹盆部侵袭性血管黏液瘤的CT特征

CT Manifestations of Aggressive Angiomyxoma in Abdomen and Pelvis

目的分析腹盆部侵袭性血管黏液瘤的增强CT表现。资料与方法回顾性分析2015年1月—2020年12月北京大学国际医院经手术病理确诊的12例腹盆部侵袭性血管黏液瘤患者的临床资料及增强CT表现,定量评估肿瘤的强化特征。结果12例病灶最大径10.1~31.7 cm,平均(15.7±6.7)cm。11例跨盆膈生长,病灶与邻近结构分界不清。CT平扫病灶密度明显低于肌肉,增强扫描不均匀渐进性强化,高密度区动脉期11例呈轻微或轻度强化,静脉期10例呈轻中度强化,低密度区12例两期均呈轻微或轻度强化。10例可见分层征或漩涡征。8例可见明显强化的小血管影。结论腹盆部侵袭性血管黏液瘤的增强CT表现具有一定特征,年轻女性发现跨盆膈生长肿物,不均匀渐进性强化,多见分层征或漩涡征及明显强化的小血管影,认识以上影像学特征有助于提高诊断水平。

Purpose To analyze the CT manifestations of aggressive angiomyxoma(AAM)in abdomen and pelvis.Materials and Methods Clinical data and contrast-enhanced CT features of 12 AAM patients with surgical incision and confirmed by pathology from January 2015 to December 2020 in International Hospital of Peking University were retrospectively analyzed,and the enhancement characteristics of the tumor were quantitatively evaluated and recorded.Results The maximum diameter of 12 lesions was 10.1-31.7 cm,with an average of(15.7±6.7)cm.There were 11 cases with transpelvic diaphragmatic growth and unclear boundary between lesions and adjacent structures.The density of lesions at pre-enhanced CT scan was significantly lower than that of muscle,and heterogeneous and progressive enhancement was presented on contrast-enhanced CT scan.For high-density area,there were 11 cases with slight or mild enhancement at arterial phase,and 10 cases with mild or moderate enhancement at venous phase.For low-density area,there were 12 cases presented slight or mild enhancement at both the arterial and venous phases.And there were 10 cases presented layered sign or swirled sign and 8 cases with markedly enhanced small vessels.Conclusion AAM in abdomen and pelvis presents several characteristics on contrastenhanced CT scan.The mass growing across the pelvic diaphragm in young women presents heterogeneous and progressive enhancement on contrast-enhanced CT scan.Swirled sign or layered sign and markedly enhanced small vessels are commonly manifested.Understanding these imaging features is helpful to improve the diagnostic level.