CT在原发性腹膜后肿瘤诊断中的价值评估

目的：评估CT在原发性腹膜后肿瘤诊断巾的价值。材料和方法：回顾性分析经手术和病理证实的30例原发性腹膜后肿瘤的CT平扫和增强表现、并与手术病理结果对照、结果：腹膜后肿瘤的主要定位征象为腹膜后器官和血管受压前移或侧移，肿瘤与相邻后腹壁或盆壁肌肉、脂肪间隙不清晰或消失，肿瘤与腹腔内脏器间隔的完整．术前CT定位诊断准确率为867％(26／30)；对良恶性判断的准确率为833％（25／30)；神经源性肿瘤表现为水样密度或软组织密度，脂肪肉瘤呈现为囊实性或软组织密度肿块，嗜铬细胞瘤以囊变和明显强化为主要表现，畸胎瘤、脂肪瘤各有特征性表现，术前病理组织类型判断准确率为33.3％(10／30)。结论：CT对原发性腹膜后肿瘤定位诊断可靠．对肿瘤良恶性预测具有帮助作用，对病理组织类型估计能提供线索和有助于鉴别诊断。     

卵巢肿瘤的CT诊断与鉴别诊断

目的：提高卵巢肿瘤CT诊斯的正确性。材料和方法：回顾28例37个经手术病理证实卵巢肿瘤CT资料，分析肿块车身CT特征(囊性，实性，囊实性)，及其伴同变化。讨论良、恶性卵巢肿瘤的定位与定性诊斯。结果：全腹部，大间距，多次的CT检查技术可对较大的卵巢肿瘤与卵巢外肿块作出鉴别。囊性肿块80%为良性，实性肿块87．6%为恶性，而囊实性肿块的良、恶性分别为57.14%与与42．86％。结合肿块外形轮廓、囊实性成分比例、伴发的腹水及邻近脏器变化等CT表现可对本组术前误诊病例及CT表现不典型者作出良、恶性鉴别。结论：CT检查可对卵巢肿瘤的定位及良、恶性作出定性诊断。     

软组织肿瘤MRI诊断探讨

目的：探讨MRI对软组织肿瘤定性诊断和良恶性的鉴别,方法：回顾性分析16例软组织肿瘤的MRI表现,所有病例均经手术后病理证实,其中良性10例,恶性6例,结果：MRI定性诊断正确率68．7％,良恶性区分正确率为93．7％,良性诊断正确率为90％,恶性诊断正确率为33．3％,结论：MRI对良恶性区分诊断,对良性肿瘤的生物组织学定性诊断很有价值,对软组织肿瘤的定性诊断存在局限性,对恶性肿瘤生物组织学诊断价值较低。     

肾上腺肿瘤影像学检查的临床应用价值(附102例分析)

目的：评价各种影像学检查方法诊断肾上腺肿瘤的临床价值,为临床医师合理选择和设计检查程序提供参考。材料与方法：以手术病理为依据,用比较影像学的方法,对各种影像学检查方法的定位、定性诊断正确率对比分析。结果：102例肾上腺肿瘤中良性肿瘤84例（内含囊性占位10例）,恶性肿瘤18例。IVP、BUS、CT、CDFI、MRI的术前定位诊断正确率分别为46．3％、91．6％、96.9％、94．1％、92.9％,定性诊断正确率分别为13.4％、83.2％（鉴别囊、实性）、69.4％、64.7％、78.6％;综合影像组则高达100％及84．3％。结论：IVP定位、定性诊断正确率低;BUS对囊、实性的识别力高;IVP＋BUS可作为肾上腺肿瘤的筛选手段;CT、CDFI、MRI对肾上腺肿瘤的定位诊断正确率高,定性诊断正确率相近,对鉴别良恶性有一定价值。综合影像检查可发挥多种检查的互补作用,明显提高肾上腺肿瘤的诊断正确率。     

腹膜后神经鞘瘤的CT表现分析

目的 :分析腹膜后神经鞘瘤的CT表现,以提高其诊断准确率及良恶性鉴别诊断水平。方法 :收集经手术病理证实的腹膜后神经鞘瘤16例,男12例,女4例,平均年龄46岁;良性10例,恶性6例;术前均行CT平扫及增强扫描。结果:大多数肿瘤呈圆形或椭圆形,位于腹膜后;肿瘤呈完全实性5例,完全囊性8例,囊实性3例。恶性病变较大而不规则。平扫3例可见钙化。增强扫描16例强化均不规则。3例周围组织可见侵犯,1例可见椎体转移。结论:腹膜后间隙发生、有明显囊变、增强扫描呈斑片状渐进性强化应考虑神经鞘瘤,CT检查对本病诊断及良恶性鉴别有重要意义。     

腹膜后神经源性肿瘤的CT诊断

目的:分析腹膜后神经源性肿瘤的CT表现,提高对良、恶性腹膜后神经源性肿瘤的鉴别诊断能力。方法:对23例经手术病理证实的腹膜后神经源性肿瘤的CT征象进行回顾性分析。结果:良性13例、恶性10例。13例良性神经源肿瘤CT大多表现为圆形、类圆形软组织肿块,密度均匀,轮廓光滑,其中神经鞘瘤和节细胞神经瘤可见斑点状钙化。10例恶性神经源性肿瘤,CT显示瘤体大而不规则,混杂密度,边缘不光滑,肿瘤可液化坏死、融合或侵蚀周围组织。CT增强扫描肿瘤表现为均匀或不均匀强化。CT对其良、恶性的诊断符合率为78%,组织类型诊断符合率为60.9%。结论:腹膜后神经源性肿瘤的好发部位有一定特征性,结合CT表现有助于良、恶性的鉴别,但对病理组织类型诊断有局限。     

浆液性卵巢肿瘤的CT诊断

目的 分析浆液性卵巢肿瘤的CT影像特征，探讨其良恶性表现。资料与方法 回顾分析1996年1月－2001年4月39例53个经手术病理证实为浆液性卵巢肿瘤的CT影像资料，对肿瘤进行定位、定性分析，重点观察肿瘤部位、内部密度、分隔、瘤壁、囊内外赘生物、软组织成分以及腹水、腹膜、网膜种植及淋巴结转移，并与手术病理所见对照，比较浆液性卵巢肿瘤良恶性的影像特点。结果 肿瘤位于附件区者占66％（35／53），最大直径3－40cm。肿块影像分3型：I型囊性（n=13);Ⅱ型囊实性，包括Ⅱa型以囊性为主（n=19),Ⅱb型混合性（n=12),Ⅱc型以实性为主（n=7)；Ⅲ型实性（n=2)。结论 浆液性卵巢肿瘤最常见部位为附件区。最常见的类型为I、Ⅱa、Ⅱb型。良性肿瘤以I型常见，恶性肿瘤以Ⅱa、Ⅱb型常见。CT可很好地显示卵巢肿瘤的内部特征，对I、Ⅱa、Ⅱb型浆液性卵巢肿瘤的良恶性鉴别有一定价值。     

原发性腹膜后肿瘤CT诊断（附50例分析）

目的：分析原发性腹膜后肿瘤的CT表现，探讨CT对其鉴别诊断要点。材料和方法：50例经手术和病理证实的原发性腹膜后肿瘤，其中良性15例，恶性35例，均行CT平扫及增强检查。结果；CT定位诊断正确46例，占92％。定性诊断正确36例，占72％。结论：CT对原发性腹膜后肿瘤的鉴别诊断有重要意义。     

CT对甲状腺肿瘤的鉴别诊断

目的：探讨CT对甲状腺良恶性肿瘤的诊断及鉴别诊断价值。方法：分析经手术病理证实的10例良恶性甲状腺肿瘤的CT表现，其中甲状腺腺瘤6例，结节状甲状腺肿2例．各种恶性肿瘤2例，并进行统计学处理。结果：腺瘤边界光滑，增强后3例显示完整强化环，2例表现为结节样强化。2例结节性甲状腺肿病灶局限，表现为囊性低密度影，边缘光滑，可见到囊壁。恶性甲状腺肿瘤呈等或混杂密度，边界不清，强化不均，并向邻近组织侵犯。结论：CT在甲状腺肿瘤的诊断和鉴别中具有重要价值。     

腹膜后原发肿瘤的CT表现

目的　探讨腹膜后原发肿瘤的特征性CT表现。材料与方法　对 2 5例经穿刺活检或手术后病理证实的腹膜后原发肿瘤的CT表现进行回顾性分析。结果　CT显示腹膜后原发肿瘤的敏感性为 10 0 % ,定位诊断正确率为 84.0 % ,良、恶性定性诊断率为6 8.0 %。肿瘤径线较大 ,腹膜后器官和相邻的血管受压移位 ,肿瘤与邻近腹腔内器官间的脂肪间隙中断或消失 ,以及与邻近盆壁和/或腹后壁间界限不清均为肿瘤定位、定性特征性CT表现。结论　CT对腹膜后原发肿瘤定位、定性诊断有一些重要的征象     

原发性腹膜后肿瘤的影像学诊断

原发性腹膜后肿瘤来源复杂，周围脏器多。旨在探讨影像学检查的诊断价值。材料与方法：回顾性分析４６例病理证实的腹膜后肿瘤的Ｘ线、ＣＴ及超声表现，并与手术所见作对照分析。Ｂ超及ＣＴ具较高的定位诊断价值。ＣＴ可较好地显示肿瘤的境界及质地，对腹膜后肿瘤的定性诊断有一定的帮助。     

卵巢肿瘤的CT诊断

目的：提高对卵巢肿瘤ＣＴ表现的认识及诊断。方法：详细分析了４２例经病理证实的卵巢肿瘤的ＣＴ表现。结果：（１）非赘生性囊肿和囊腺瘤的特征为薄壁的囊性肿物，壁与间隔薄且规则。ＣＴ可识别囊内新近出血。（２）肿物内含脂肪成份，囊壁隆起的实性结节处见结节状钙化或牙齿是囊性畸胎瘤定性诊断的特征性表现。（３）恶性囊性肿瘤的特征为囊壁与间隔不规则增厚，其内可发现乳头状或不规则实性成份。结论：ＣＴ是诊断本病的重要的影像学检查手段。结合临床综合分析，有助于提高诊断准确性。     

Imaging of gastrointestinal stromal tumor (GIST): relation between CT findings and grade of malignancy

PURPOSE: To report the relation between CT findings and the grade of malignancy in gastrointestinal stromal tumor (GIST), especially the uncommitted type of GIST. MATERIALS AND METHODS: A total of 14 patients with histologically proven GIST (uncommitted type) underwent CT. Tumors were divided into three grades. HISTOLOGICALLY: Benign (mitotic index [MI] < 2/10 high-power fields [HPF]), borderline (2/10 HPF < or = MI < or = 5/10 HPF), and malignant (5/10 HPF < MI). We evaluated tumor size, cystic component, margin, and early enhancement. RESULTS: All benign tumors were smaller than 5 cm, and most malignant tumors reached 5 cm. The size of borderline tumors was between the sizes of benign and malignant tumors. No benign tumors had cystic components, whereas all borderline and malignant tumors except for one case had cystic components. Only two huge malignant tumors had unclear margins. The relation between early enhancement and the grade of malignancy showed no tendency, but all duodenal tumors showed marked early enhancement irrespective of grade. CONCLUSION: The grade of malignancy of GIST (uncommitted type) and size, presence of cystic components, and margin were highly correlated. That is, 1) tumors smaller than 5 cm with no cystic components can be diagnosed as benign, whereas 2) tumors that have cystic components are borderline or malignant. 3) Tumors that have cystic components and unclear margin can be diagnosed as actively malignant.     

Brenner tumor of the ovary: CT and MR findings

PURPOSE: The purpose of this study was to determine the CT and MR characteristics of Brenner tumors, rare epithelial neoplasms of the ovary. METHOD: CT and MR scans of eight pathologically proven Brenner tumors of the ovary (seven benign, one malignant, and one associated with mucinous cystadenoma) were retrospectively reviewed. The masses were analyzed for location, size, external configuration, internal architecture, enhancement pattern, presence of calcification, and metastatic spread. RESULTS: The patients' median age was 63 years (range 39-79 years), and the mean size of the tumors was 11.4 cm (7.5-17 cm). All tumors were unilateral and had a well-defined margin. The mass was mostly solid in three, mostly cystic in one, and "mixed" solid and cystic in four cases. The tumors with cystic components (n = 5) were mostly multilocular in appearance (n = 4). All the solid components showed mild homogeneous enhancement on postcontrast CT and MRI. Extensive amorphous calcification within the solid component on CT was seen in five of six cases (83%). No characteristic findings discriminating malignancy from benign Brenner tumor could be found. CONCLUSION: Extensive amorphous calcification in a solid mass or solid component in a multilocular cystic mass is a characteristic finding of Brenner tumor of the ovary on CT and MRI.     

腮腺良恶性肿瘤的CT鉴别诊断

目的:探讨CT对腮腺良恶性肿瘤的鉴别诊断价值.方法:回顾性分析20例经手术病理证实的腮腺肿瘤的CT表现,其中良性肿瘤16例,恶性肿瘤4例.结果:本组中CT术前诊断符合率为90%.良性肿瘤的主要CT表现为边界清楚15例(94%),平均大小为8 cm3;位于浅叶10例(63%),深叶1例(6%),5例同时累及深、浅叶;钙化1例(6%),囊变3例(19%),头颈部淋巴结增大2例(13%).恶性肿瘤中边界清楚1例(1/4),平均大小为13 cm3;1例(1/4)位于浅叶,2例(2/4)位于深叶,1例同时累及深、浅叶;头颈部淋巴结增大3例(3/4).结论:腮腺肿瘤的CT表现有一定特征性,CT对良恶性腮腺肿瘤的鉴别诊断有一定价值.     

Application of dynamic CT for various diseases in the oral and maxillofacial region

OBJECTIVE: To investigate whether dynamic CT enables quantitative differentiation between inflammation, benign tumors, and malignant tumors in oral and maxillofacial regions. METHODS: Sixteen malignant tumors (14 squamous cell Ca, one adenoid cystic Ca, one mucoepidermoid Ca), six benign tumors (one Warthin tumor, two pleomorphic adenomas, one lipoma, one Schwanoma, one hemangioma), and seven inflammation cases (three submandibular adenitis, two osteomyelitis, two perimandibular inflammations) were examined. Contrast agent (0.8 ml/kg) was injected intravenously at 5 ml/s. CT (Toshiba TCT 900S) scanning was performed at the time of the beginning of contrast medium injection. Parameters from the time-density curve were investigated: peak height (PH), relative CT value from the base CT value when the curve reached peak point; peak time (PT), the time when the curve reaches the peak point from contrast medium infusion; transit time (TT), time between two transit points on the time-density curve; and peak time ratio (PR), the ratio of peak time from the lesion to the artery and peak time from the vein to the artery. RESULTS: PH was highest in inflammation, followed by malignant tumors and benign tumors. TT was significantly longer in benign tumor cases compared with malignant tumor and inflammation cases. PR for malignant tumor and inflammation were between the artery and vein phase, and that for benign tumor was beyond the vein phase. CONCLUSION: Parametrical analysis of a contrast enhanced dynamic CT study may serve to differentiate the lesions in the oral and maxillofacial region.     

Intraductal papillary mucinous tumors of the pancreas: thin-section helical CT findings

OBJECTIVE: The purpose of this study was to evaluate the thin-section helical CT findings of intraductal papillary mucinous tumors and to investigate whether helical CT could distinguish between malignant and benign intraductal papillary mucinous tumors. MATERIALS AND METHODS: Twenty-seven patients (nine with malignant and 18 with benign intraductal papillary-mucinous tumors) underwent thin-section (3- or 5-mm) helical CT. Two-phase enhanced CT was started 30 and 60-70 sec after injection of contrast material at 3 ml/sec. RESULTS: In six patients (22.2%), a bulging papilla was depicted on CT. Twenty-five patients (92.6%) had a dilated main pancreatic duct. Cystic lesions were seen in 25 patients (92.6%). Thirteen lesions (48%) were located in the uncinate process, seven (25.9%) were in the head, two (7.4%) were in the body, and three (11%) were in the tail. The cystic lesion was unilocular in five patients (18.5%) and multilocular with a lobulated margin in 20 patients (74%). Communication between the main pancreatic duct and the cystic lesion was depicted in 19 patients (70.4%). The papillary projections corresponding to 3-mm or larger papillary neoplasms were depicted in five patients (18.5%). The bulging papilla was more often observed in malignant than in benign intraductal papillary mucinous tumors (p < 0.05). The caliber of the main pancreatic duct was significantly larger in patients with malignant intraductal papillary mucinous tumors (p > 0.001). CONCLUSION: The most frequently found feature of intraductal papillary mucinous tumors was a lobulated multilocular cystic lesion located in the uncinate process and in contiguity with the dilated main pancreatic duct. In some patients, a bulging papilla and papillary projections in the ducts, which were specific findings, were visualized on CT. The bulging papilla and the caliber of the main pancreatic duct helped differentiate malignant from benign intraductal papillary mucinous tumors.     

卵巢畸胎瘤的CT表现

目的:研究卵巢畸胎瘤的CT表现,提高CT诊断的准确性。方法:搜集手术病理证实的卵巢畸胎瘤18例共计20个肿瘤,对其CT表现作回顾性分析。结果:18例卵巢畸胎瘤,平均34.2岁,其中良性囊性畸胎瘤18个,恶性未成熟畸胎瘤2个。右侧9个,左侧11个,平均最大直径87mm。17个呈圆形或椭圆形,3个为不规则形。18个见脂质成分存在。18个良性者14个显示壁结节,2个见脂-液平面;2个恶性者密度不均匀。13个见钙化或骨化。本组20个肿瘤平扫CT的敏感度100%,特异度95%,诊断符合率为95%。结论:发生于卵巢的含有脂质成分和钙化或骨化斑者应考虑本病。     

盆腔器官外软组织肿瘤的CT诊断

目的 探讨盆腔器官外软组织肿瘤的CT表现及其诊断价值。材料与方法 回顾性分析经手术病理证实的30例原发性盆腔器官外软组织良、恶性肿瘤的CT表现。其中间叶源性肿瘤15例,神经源性肿瘤8例,胚胎残余组织源性肿瘤5例,腹膜间皮细胞肿瘤2例。结果 原发于盆腔器官外软组织肿瘤较少见,CT表现为囊性肿块者均为良性,囊实性或实性者以恶性居多。虽然肿瘤来源于多种不同组织,但CT表现可各有其特征。结论 CT是诊断盆腔器官外肺瘤的重要影像学手段,能明确肿瘤范围以及肿瘤与周围组织的关系及其性质。     

CT对腮腺病变的诊断价值

目的:评价CT对腮腺良恶性病变的诊断价值。方法:回顾性分析经手术病理证实的47例腮腺病变的CT表现。良性36例,恶性11例。CT平扫46例,增强扫描38例。结果:良性肿瘤无侵袭性,边缘清楚,密度均匀或不均匀,有钙化、囊变、坏死;炎性肿块者,灶周可有磨玻璃影,呈晕征;恶性肿瘤具有不同程度的侵袭性,多呈分叶状,不规则或浸润性生长,边缘不清。CT对腮腺病变定位准确率100% ,而对良恶性定性诊断符合率分别为恶性组72.7% ,良性组80.6% 。结论:CT对腮腺病变定位、定性诊断,特别是区别良恶性病变方面具有较高的价值