【摘要】 目的采用多排螺旋CT血管造影术(MSCTA)容积重建(VR)技术评价盆腔起源不明肿瘤的供血动脉、判断肿瘤的来源、性质。方法对37例盆腔起源不明肿瘤患者行MSCTA,采用血管生成和图像融合法重建腹部血管,通过观察肿瘤供血动脉的来源、数量、形态、起止、走行、分布、起源,初步判断肿瘤的良恶性及肿瘤是否侵犯周围脏器,并与手术结果进行对照分析。结果 MSCTA显示盆腔起源不明肿瘤的供血动脉63支,其中卵巢动脉15支(13例,均为卵巢肿瘤),子宫动脉35支(3例子宫肿瘤、15例卵巢肿瘤),肠系膜下动脉6支(2例结肠癌、3例肠道间质瘤),骶正中动脉2支(2例神经源性肿瘤),髂总动脉无名分支2支(1例淋巴瘤,1例肿瘤来源不明),腹主动脉其他分支3支,定位诊断准确率为91.89%(34/37),术前MSCTA诊断盆腔良、恶性肿瘤与手术结果符合率为89.19%(33/37)。双侧病变5例,其中3例为原发,2例为继发,MSCTA诊断准确率为100%。结论 MSCTAVR技术可显示盆腔肿瘤的供血动脉,对盆腔起源不明的肿瘤定位、定性诊断有较高价值。更多还原

【Abstract】 Objective To investigate and evaluate the relationship between the origin and feeding arteries of pelvic unknown origin neoplasms with multi-slice spiral CT angiography (MSCTA). Methods Totally 37 patients with pelvic unknown origin neoplasms underwent MSCTA,and abdominal blood vessels reconstruction (VR) with volume reconstruction based on add vessel and image fusion technique. According to the origin,quantity,distribution and arrangement of the feeding arteries,the location,nature and involved area of tumors were diagnosed and more complicated primary or secondary tumor focus were found and compared with surgical results. Results All of 63 feeding arteries of pelvic unknown origin neoplasms were showed,including 15 ovarian arteries (including ovarian tumors in 13 patients),35 uterine arteries (including uterine tumors in 3 patients,ovarian tumors in 15 patients),6 inferior mesenteric arteries (including colon tumors in 2 patients,intestinal stromal tumors in 3 patients),2 median sacral arteries (including neurogenic tumors in 2 patients),2 innominate arteries arising from common iliac artery (including lymphoma in 1 patient,unknown origins in 1 patient),and the other 3 branch arteries from abdominal aorta. The accuracy rate of localization was 91.89% (34/37). The coincidence rate of MSCTA diagnosing benign and malignant tumors preoperative was 89.19% (33/37). Five patients of bilateral pelvic neoplasms were found,including 3 primary and 2 secondary,and the diagnostic accuracy rate of MSCTA was 100% (37/37). Conclusion Showing the feeding arteries of pelvic tumors,MSCTA VR technique can qualitatively diagnose pelvic unknown origin tumors,providing the bases for clinical treatment program.更多还原