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目的探讨促纤维组织增生性小圆细胞肿瘤(DSRCT)的正电子发射体层摄影术(PET)-CT影像表现、诊断、鉴别诊断。方法经病理组织证实的2例DSRCT患者,男性,年龄均为27岁。回顾性分析其PET-CT影像学特点,并文献复习。结果PET影像表现为广泛腹、盆腔内不均质性葡萄糖代谢异常活跃灶,肿块内坏死区葡萄糖代谢呈缺失表现。CT表现为腹、盆腔内分叶状结节或团块状肿块,广泛侵及腹膜、网膜、浆膜面;内可见坏死区,伴点状钙化;增强CT呈轻中度不均质性强化,病灶对周围组织、器官呈推挤、包绕、侵犯倾向,边界不清,但与周围器官无明显起源关系。MRI显示:T1加权像病灶呈不均质性等、低信号,T2加权像病灶呈不均质性等、稍高信号,坏死区呈高信号,增强扫描呈不均质性轻中度强化。结论DSRCT罕见,临床表现复杂,病灶与浆膜关系密切,但也可发生在其他部位;PET-CT可以同机融合结构及功能显像行全身扫描,对DSRCT的诊断、分期、定位活组织检查及疗效评价有很高价值。
Objective To investigate the positron emission tomography (PET)-CT imaging manifestations, diagnosis and differential diagnosis of fibroproliferative small round cell tumor (DSRCT). Methods Two patients with DSRCT confirmed by pathology were male and their age was 27 years old. Retrospective analysis of its PET-CT imaging features, and literature review. RESULTS: PET imaging was characterized by a wide range of abdomen and pelvic heterogeneity of abnormal glucose metabolism, with necrosis of glucose metabolism in the mass. CT showed abdominal, pelvic lobulated nodules or clumps, extensive invasion of the peritoneum, omentum, serosal surface; visible necrosis area, with spotted calcification; enhanced CT showed mild to moderate heterogeneity Intensified, the lesion showed a tendency to push, wrap around, and invade the surrounding tissues and organs, and the boundary was unclear, but there was no obvious origin relationship with the surrounding organs. MRI showed: T1-weighted lesions were heterogeneous, low signal, T2-weighted lesions were heterogeneous, slightly hyperintense, necrotic areas showed high signal, and enhanced scans were heterogeneous mild to moderate enhancement. Conclusion DSRCT is rare, clinical manifestations are complex, lesions are closely related to the serosa, but can also occur in other sites; PET-CT can be performed with whole body scanning with the same structure and functional imaging, and the diagnosis, staging and localization biopsy of DSRCT can be performed. And evaluation of efficacy has high value.