CAJ | 학술논문

目的：探讨腹膜后平滑肌肉瘤的 CT 影像学特征。方法回顾性分析经手术病理证实的10例腹膜后平滑肌肉瘤患者的影像学资料。9例行 CT 平扫及增强检查，1例行 CT 直接增强检查。10例均有完整病例结果。结果病变多呈分叶状，6例与下腔静脉关系密切，呈包绕及浸润关系。3例同时累及腹部与盆腔部位。病变体积均较大，大小约6 cm×4 cm×2．5 cm～30 cm×20 cm×15 cm。CT 平扫9例呈不均匀软组织密度，1例以囊性为主，伴实性厚壁及厚分隔，增强后明显不均匀强化，8例动脉期强化幅度超过40 HU，静脉期造影剂无明显退出。1例可见邻近腰椎骨质破坏，10例均未见明显肿大淋巴结，未发现远处转移。平滑肌肌动蛋白 SMA 呈阳性表达，结蛋白 Desmin 呈现阳性表达，CD117呈现阴性。结论腹膜后平滑肌肉瘤是一种少见的肿瘤，CT 有一定的特征性表现，同时可准确定位，确定周围及邻近组织浸润及受累情况等，最终确诊依靠病理免疫组化检查。
목적：탐토복막후평활기육류적 CT 영상학특정。방법회고성분석경수술병리증실적10례복막후평활기육류환자적영상학자료。9례행 CT 평소급증강검사，1례행 CT 직접증강검사。10례균유완정병례결과。결과병변다정분협상，6례여하강정맥관계밀절，정포요급침윤관계。3례동시루급복부여분강부위。병변체적균교대，대소약6 cm×4 cm×2．5 cm～30 cm×20 cm×15 cm。CT 평소9례정불균균연조직밀도，1례이낭성위주，반실성후벽급후분격，증강후명현불균균강화，8례동맥기강화폭도초과40 HU，정맥기조영제무명현퇴출。1례가견린근요추골질파배，10례균미견명현종대림파결，미발현원처전이。평활기기동단백 SMA 정양성표체，결단백 Desmin 정현양성표체，CD117정현음성。결론복막후평활기육류시일충소견적종류，CT 유일정적특정성표현，동시가준학정위，학정주위급린근조직침윤급수루정황등，최종학진의고병리면역조화검사。
Objective To investigate the CT Imaging characteristics of retroperitoneal leiomyosarcoma. Methods Retrospective analysis the imaging datas of 10 cases proved by surgery and pathology with retro-peritoneal leiomyosarcoma.We underwent plain and enhanced CT in 9 cases,as well as direct-Enhanced CT in 1 cases.Results The number of women was more than men,which occupy for 70 percent (7/10). The mean age of the 10 patients was 48 years old.The main feature of the 10 cases was single and leaf-shaped.3 cases of them were postoperative recurrence.6 cases were closely related to the inferior vena ca-va,which had an enveloping and infiltration relationship.Lesions are large in size,ranging in size from 6× 4×2.5 cm to 30×20×15 cm.9 cases CT plain scan showed inhomogeneous soft tissue density.1 case was cystic which had solid thick wall and septum,and enhanced significantly heterogeneous enhancement.8 ca-ses of arterial phase,the enhanced level were more than 40HU,while venous phase contrast agent had no obvious exit.1 case destructed the lumbar bone which was closed to the lesion.There were no significant swelling of lymph nodes of 10 cases,no distant metastasis was found.Conclusion Retroperitoneal leiomy-osarcoma is a rare tumor,CT had some characteristic manifestations,as well as defined accurate positio-ning,such as determining the surrounding and adjacent tissue invasion and involvement.The final diagno-sis depended on Immunohistochemical examination.