摘要
目的分析腹部纤维瘤病的CT表现及临床特征,以提高对该病的认识。资料与方法回顾性分析28例经手术病理证实的腹部纤维瘤病患者的CT表现及临床资料。28例中,原发肿瘤21例,其中腹内肿瘤10例(肠系膜7例,腹膜后3例),腹壁肿瘤11例;复发肿瘤7例,其中腹内4例(肠系膜及腹膜后各2例),腹壁肿瘤3例。28例中,腹壁纤维瘤病14例均为女性患者,其中20～40岁者12例(85.7%)。临床症状:腹部肿块26例(92.9%),下腹疼痛2例(7.1%)。1例(3.6%)伴有Gardner综合征,7例(25%)既往有腹部手术史,3例(10.7%)肿瘤为多灶。结果 21例原发肿瘤中,平扫5例CT值均低于肌肉,增强扫描20例,无强化2例,轻度强化6例,中等度强化10例,明显强化2例,双期扫描肿瘤延迟强化2例。原发肿瘤门静脉期增强CT值(74.15±20.61)HU,同层肌肉CT值(62.80±10.56)HU,两组CT值呈正态分布,经配对检验,肿瘤强化程度略高于肌肉,差异有统计学意义(t=2.867,P=0.010)。复发肿瘤7例,由于病例数较少,无法进行统计学处理。所有肿瘤均未出现出血、坏死。原发肠系膜肿瘤位于小肠系膜6例(85.7%),多呈类圆形,大部分边界清楚,可累及肠壁浆膜,甚至肌层,包绕肠系膜血管,2例肿瘤边缘区含有脂肪成分。原发腹膜后肿瘤边界不清,边缘毛糙,侵犯腹膜后器官,包绕腹膜后大血管。原发腹壁肿瘤呈类圆形或梭形,沿腹直肌或腹斜肌长轴生长,5例边界清楚(45.5%)。所有复发肿瘤均边界不清,强化程度与原发肿瘤相仿,侵袭性增强。结论腹部纤维瘤病CT表现有一定的特异性,结合临床病史大部分肿瘤可明确诊断。
Objective To analyze the CT manifestations of abdominal fibromatosis,in order to improve the diagnosis.Materials and Methods CT and clinical data of 28 cases with pathologically confirmed abdominal fibromatosis were retrospectively analyzed.There were 21 cases of primary tumor including intra-abdominal tumor in 10 cases（7 cases of mesenteric tumor,3 cases if retroperitoneal tumor）and abdominal wall tumor in 11 cases.There were 7 cases of recurrent tumor,4 cases were intra-abdominal tumor（mesenteric and retroperitoneal tumor in 2 cases respectively）,and 3 cases were abdominal wall tumor.Results The patients included 19 females and 9 males with median 31 years old（aged 21 to 65 years）.All the 14 cases of abdominal wall fibromatosis were female,85.7%（12 cases）were 20 to 40 years old.Clinical symptoms were abdominal mass in 26 cases（92.9%）,abdominal pain in 2 cases（7.1%）,1 case associated with Gardner syndrome（3.6%）,7 cases of previous abdominal surgeries（25%）,3 cases of multiple lesions（10.7%）.Imaging findings：For 21 cases of primary tumors,CT value of lesions were lower than that of muscle.Twenty cases performed contrast CT,no enhancement in 2 lesions,mild enhancement in 6 cases,moderate enhancement in 10 cases,significant enhancement in 2 cases.The mean CT value of primary tumor was（74.15±20.61）HU on portal vein enhanced phase,while the CT values of muscle was（62.80±10.56）HU.The CT value had significant difference between tumor and muscle（t=2.867,P=0.010）.Hemorrhage or necrosis was not seen in all tumors.Six cases（85.7%）of primary mesenteric tumors in the small intestine mesentery mostly showed oval mass with clear boundary,some tumors adjacent to intestinal wall involved intestinal serosa or even muscle,some tumors surround the mesenteric vessels.Two tumors contained fat in marginal zone.Primary retroperitoneal tumors showed unclear border,involved retroperitoneal organs,surround the large retroperitoneal vessels.Primary abdominal tumors were round or spindl
出处
《临床放射学杂志》
CSCD
北大核心
2010年第12期1633-1636,共4页
Journal of Clinical Radiology
