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目的 分析盆部原发肿瘤CT增强表现特征 ,探讨产生各种影像表现的病理学和解剖学基础。方法 回顾性分析 14例经病理学证实的盆部原发肿瘤CT增强表现 ,包括病灶大小、密度、边缘、强化特征 ,肿块所在的解剖部位及其与邻近组织器官和间隙的关系等。结果 良性肿瘤 3例 ,恶性肿瘤 11例。肿块位于盆腹膜腔和腹膜外间隙各 6例 ,盆腹膜腔和腹膜外间隙同时受累 2例。CT增强表现为实质性 8例 ,囊实性 6例 ;均匀强化 3例 ,不均匀强化 11例。肿块周围脂肪间隙清晰和受侵犯各 7例。 4例病灶内出现钙化 ,其中良性畸胎瘤 2例 ,恶性畸胎瘤和类癌各 1例。结论 CT增强扫描能准确判断盆部原发肿瘤的解剖位置及其与邻近解剖结构的毗邻关系 ,初步判断肿瘤的良恶性 ,对畸胎瘤能做出比较明确的定性诊断。
Objective To analyze the features of CT enhancement in primary pelvic tumors and to explore the pathological and anatomic basis of various imaging findings. Methods Retrospective analysis of 14 cases of pathologically confirmed primary tumor of the pelvis showed enhanced CT findings including lesion size, density, margins, enhancement features, the anatomy of the tumor and its relationship with adjacent organs and gaps. Results 3 cases of benign tumors, 11 cases of malignant tumors. The tumor was located in the pelvic peritoneal cavity and extraperitoneal space in 6 cases, pelvic peritoneal cavity and extraperitoneal space both involved in 2 cases. CT enhancement showed substantial in 8 cases, cystic solid in 6 cases; uniform enhancement in 3 cases, uneven enhancement in 11 cases. Fat clearance around the lumps were clearly and infringed in 7 cases. Four cases of calcification within the lesions, including benign teratoma in 2 cases, malignant teratoma and carcinoid in 1 case. Conclusion CT enhanced scan can accurately determine the anatomical location of the primary tumor in the pelvis and its adjacent relationship with the adjacent anatomical structures. The preliminary diagnosis of benign and malignant tumors can make a definite diagnosis of teratoma.