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目的探讨腹部促结缔组织增生性小圆细胞肿瘤(desmoplastic small round cell tumor,DSRCT)的CT、MRI表现。资料与方法回顾性分析经病理证实的7例DSRCT患者的临床及影像学资料,7例中单发2例,多发5例;病灶直径>10cm者5例。7例均行CT检查,2例在1周内行MRI。结果腹、盆腔内可见分叶状或结节状低密度肿块,其内有小片状坏死,5例可见斑点状钙化;增强扫描2例轻度强化,5例中度强化;病灶与浆膜面关系密切,对周围组织及血管呈推移、包绕、侵犯倾向,但无明显起源关系,5例病灶内可见分隔状强化血管影。2例伴腔积液;2例肝转移、骨转移;3例淋巴结转移。MR T1WI上呈等低信号,T2WI呈稍高信号,其内可见更高信号的囊变坏死区。结论CT和MRI表现为腹、盆腔内巨大结节状或分叶状肿块,特别是位于膀胱后方或子宫直肠区域,与周围器官无明显起源关系,广泛腹膜、网膜种植,肿瘤呈不均匀低密度,内见斑点状钙化及小片状坏死,腹腔积液少见,增强扫描呈轻、中度强化,可考虑DSRCT的可能。
Objective To investigate CT and MRI findings of desmoplastic small round cell tumor (DSRCT) in the abdomen. Materials and Methods Retrospective analysis of 7 cases of DSRCT confirmed by pathology clinical and imaging data, 7 cases of single in 2 cases, 5 cases of multiple lesions; lesions diameter> 10cm in 5 cases. Seven patients underwent CT examination and two patients underwent MRI within one week. Results Abdominal and pelvic lobular or nodular low-density mass showed a small piece of necrosis, 5 cases of visible plaque calcification; enhanced scanning in 2 cases of mild enhancement, 5 cases of moderate enhancement; lesions and serosa Closely related to the surrounding tissue and blood vessels were moving, encircling, aggressive tendency, but no significant relationship between the origin, 5 cases of lesions seen enhanced septal vessels. 2 cases with effusion; 2 cases of liver metastases, bone metastases; 3 cases of lymph node metastasis. MR T1WI showed a low signal, T2WI was slightly higher signal, which can be seen within a higher signal capsule necrosis. Conclusions CT and MRI manifestations of abdominal, pelvic huge nodular or lobulated mass, especially located in the posterior or uterine rectum of the bladder, with no obvious relationship with the surrounding organs, extensive peritoneal, omentum implantation, the tumor was uneven low Density, spotted calcification and small pieces of necrosis, ascites rare, enhanced scan was mild to moderate enhancement, may consider the possibility of DSRCT.