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目的:分析腹膜后间质瘤的临床、病理组织学特征及MSCT表现,探讨MSCT对本病的诊断价值。方法:回顾性分析经手术和病理证实的12例腹膜后间质瘤的临床及MSCT资料,所有病例术前均进行了CT平扫及增强检查。结果:12例患者中,男性7例,女性5例,40岁以上8例,平均年龄55岁,主要临床表现为腹部肿块和疼痛。12例均表现为腹膜后腔软组织肿块,肿瘤最大直径3.0～21.0 cm,平均11.0 cm。肿瘤呈类圆形7例,不规则形5例。其中CT平扫密度均匀2例中,增强扫描1例均匀强化,另1例不均匀分隔状强化。CT平扫密度不均匀10例中均见囊变坏死区,其中钙化2例、出血2例,增强扫描实质部分中度以上强化,囊变坏死部分不强化,呈分隔状。病理结果提示良性1例,低度恶性潜能3例,恶性8例,远处转移3例。免疫组化表现CD117阳性12例,CD34阳性7例。结论:腹膜后间质瘤多见于中老年患者,临床症状少;MSCT表现具有一定特征,能较好地反映病变的病理组织学特点,对本病的诊断及鉴别诊断有重要价值。
OBJECTIVE: To analyze the clinical, histopathological features and MSCT findings of retroperitoneal stromal tumors and to explore the diagnostic value of MSCT in this disease. Methods: The clinical and MSCT data of 12 cases of retroperitoneal stromal tumors confirmed by surgery and pathology were retrospectively analyzed. All patients underwent CT scan and enhanced CT before operation. Results: Of the 12 patients, 7 were male, 5 were female, 8 were over 40 years old, with an average age of 55 years. The main clinical manifestations were abdominal mass and pain. All 12 cases showed retroperitoneal soft tissue mass with the largest diameter of 3.0-21.0 cm, an average of 11.0 cm. Tumor was round in 7 cases, irregular in 5 cases. Among them, two cases of even density of CT scan were uniform, one case of enhanced scan was uniform and the other one was unevenly divided. In 10 cases with uneven CT scan density, cystic degeneration areas were seen. Among them, 2 cases of calcification and 2 cases of hemorrhage were observed. Pathological findings suggest benign in 1 case, low malignant potential in 3 cases, malignant in 8 cases and distant metastasis in 3 cases. Immunohistochemistry showed CD117 positive in 12 cases, CD34 positive in 7 cases. CONCLUSIONS: Retroperitoneal stromal tumors are more common in middle-aged and elderly patients with less clinical symptoms. MSCT has certain characteristics that can better reflect the histopathological features of the lesion and is of great value in the diagnosis and differential diagnosis of this disease.