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目的探讨腹膜后原始神经外胚层肿瘤(primitive neuroectodermal tumors,PNET)的CT及血管造影表现。资料与方法回顾性分析6例经病理证实的腹膜后PNET的CT和血管造影表现。结果 6例中,5例行CT平扫和增强扫描,CT平扫1例,血管造影4例。CT表现为腹膜后较大囊实性软组织肿块,最大直径约17.0 cm,边界清晰或不清,形态规则或不规则,呈浸润性或膨胀性生长;平扫肿块密度不均,CT值约14～47 HU,3例示不同程度坏死囊变,2例可见小片状出血灶,1例可见钙化灶。增强扫描肿块呈轻中度不均匀强化,CT值升高约13～25 HU。肿块包绕肾血管2例,累及肾脏并肾血管受压移位4例,肾盂积水4例,累及左肾上腺2例、胰腺1例、左侧腰大肌2例、左侧膈肌1例、左侧输尿管1例。3例可见患侧肾脏出现2支肾动脉,2例腹膜后可见多发淋巴结肿大,1例双侧膈脚后及左颈部淋巴结肿大。3例血管造影显示病灶血供不丰富,1例显示病灶呈团块状肿瘤染色征。结论腹膜后PNET的CT和血管造影表现缺乏特异性,与腹膜后其他恶性肿瘤不易鉴别。
Objective To investigate the CT and angiographic findings of retroperitoneal primitive neuroectodermal tumors (PNETs). Materials and Methods Retrospective analysis of 6 cases of pathologically confirmed retroperitoneal PNET CT and angiography. Results Among the 6 cases, CT scan and enhanced scan were performed in 5 cases. CT scan was performed in 1 case and angiography in 4 cases. CT showed a large retroperitoneal cystic soft tissue mass, the maximum diameter of about 17.0 cm, the border is clear or unclear, regular or irregular morphology, was invasive or expansive growth; swell uneven mass density, CT value of about 14 ~ 47 HU, 3 cases showed necrosis of varying degrees of cystic degeneration, 2 cases showed small hemorrhagic lesions, calcification in 1 case. Enhanced scan mass showed mild to moderate non-uniform enhancement, CT value increased about 13 ~ 25 HU. 2 cases of renal masses surrounded by renal masses and renal vessels, 4 cases of hydronephrosis, 4 cases of hydronephrosis, 2 cases of left adrenal gland, 1 case of pancreas, 2 cases of left psoas muscle, 1 case of left diaphragm, Left ureter in 1 case. Three cases showed ipsilateral renal 2 renal artery, 2 cases of multiple retroperitoneal lymph nodes, 1 case of bilateral phrenic feet and left cervical lymph nodes. Three cases of angiography showed that the blood supply to the lesion was not abundant, and one case showed lesions of massive tumor staining. Conclusion Retroperitoneal PNET CT and angiography performance of the lack of specificity, and other retroperitoneal malignant tumors is not easy to identify.