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目的:探讨腹膜后脂肪肉瘤的CT平扫和增强表现及鉴别诊断要点。方法:回顾12例经手术病理证实的腹膜后脂肪肉瘤的CT平扫和增强资料,12例均行CT平扫,7例加作增强。分析不同组织类型脂肪肉瘤的CT表现与病理的相关性。结果:与病理对照,脂肪瘤样脂肪肉瘤(LLS)1例。硬化性脂肪肉瘤(SLS)1例,黏液样脂肪肉瘤(MLS)1例,圆细胞性脂肪肉瘤(RCLS)1例,去分化脂肪肉瘤(DDLS)1例,混合成分7例。CT图像上,LLS表现为脂肪密度肿块,不均质,有分隔;MLS平扫表现为均匀的水样密度肿块,增强扫描可见网状、片状或岛状强化;RCLS表现为无脂肪的软组织肿块,与其他类型的软组织肿瘤难以鉴别;DDLS表现为明显强化的软组织肿块,常伴有分化良好的脂肪瘤样组织。结论:不同组织学亚型的脂肪内瘤其CT表现有所不同,CT表现的差异取决于病变内不同组织学亚型的比例、分布及混合的方式。本组中,腹膜后脂肪肉瘤多以混合形式存在,了解这些CT表现特点有助于脂肪内瘤的术前诊断及分型。
Objective: To explore the CT scan and enhanced performance of retroperitoneal liposarcoma and the main points of differential diagnosis. Methods: 12 cases of retroperitoneal liposarcoma confirmed by surgery and pathology were retrospectively reviewed by CT scan and enhanced data. All of them were performed CT plain scan and enhanced by 7 cases. To analyze the correlation between CT features and pathology of different types of liposarcoma. Results: Compared with pathology, 1 was liposarcoma liposarcoma (LLS). 1 case of sclerosing liposarcoma (SLS), 1 case of mucinous liposarcoma (MLS), 1 case of round cell liposarcoma (RCLS), 1 case of dedifferentiated liposarcoma (DDLS) and 7 cases of mixed components. On the CT images, LLS presented as lumps of fat density, heterogeneous, and separated; MLS showed uniform water-like density mass with enhanced scan showing reticular, lamellar or island-like enhancement; RCLS showed no fat-like soft tissue Lumps, and other types of soft tissue tumors is difficult to identify; DDLS showed significantly enhanced soft tissue mass, often accompanied by well-differentiated lipoma-like tissue. CONCLUSION: The CT findings of intra-fat tumor of different histological subtypes are different. The difference of CT manifestations depends on the proportion, distribution and mixing of different histological subtypes in the lesion. In this group, the majority of retroperitoneal liposarcomas exist as mixed forms. Understanding the features of these CT findings is helpful for the preoperative diagnosis and classification of lipoma.