摘要
目的探讨原发性肾上腺平滑肌肉瘤的CT特征,以提高其CT诊断水平。方法回顾性分析2009年8月—2019年1月在四川大学华西医院放射科行CT检查,且术后经病理学检查证实为原发性肾上腺平滑肌肉瘤患者的术前CT检查资料。在CT图像上,观察病变的位置、大小、形态、密度、强化特点、与周围结构关系及是否发生转移,并结合国内外原发性肾上腺平滑肌肉瘤文献,总结该病的CT特征。结果最终纳入5例患者,均为左侧单发病灶。原发性肾上腺平滑肌肉瘤特征性的增强CT表现为边界清楚但不规则的较大肿块、多中心出现并同时累及肿块中心和边缘的坏死灶、未坏死部分持续增高的强化程度以及肿瘤内新生血管或针尖状血管断面等。5例患者中,2例术后复发,3例术后失访。结论原发性肾上腺平滑肌肉瘤是一种少见肿瘤,增强CT表现具有特征性,提高对该病CT表现的认识有助于术前诊断,指导临床治疗。
Objective To investigate the CT and pathological findings of adrenal leiomyosarcoma,so as to improve the accuracy of diagnosis.Methods The clinical data of patients with adrenal leiomyosarcoma who were confirmed with surgery and pathology in West China Hospital,Sichuan University between August 2009 and January2019 were retrospectively analyzed.Patients without pre-operation CT examination were excluded.The CT imaging features of the disease,including the location,size,shape,enhanced features,surrounding structures and metastasis of adrenal leiomyosarcoma were evaluated on CT images,respectively.Results Finally 5 patients were included.All of them had left single lesion.Enhanced CT features delineated large masses with well-defined but irregular boundaries,multicentric necrosis involving both the center and edge,continuous increased enhancement of the non-necrotic area,and cross-section of neovascularization or needle-tip vessels in the tumors.Among the 5 patients,2 had postoperative recurrence and 3 lost follow-up.Conclusions Primary adrenal leiomyosarcoma is rare.Adrenal leiomyosarcoma could be correctly diagnosed with CT enhanced examination,which are helpful for making surgical strategies.
作者
钟欢欢
梁译文
张丽芝
ZHONG Huanhuan;LIANG Yiwen;ZHANG Lizhi(Department of Radiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2020年第7期833-838,共6页
West China Medical Journal
