计算机二级包宏伟试题,盆腹部起源不明巨大肿瘤的CTA诊断价值探讨

摘要

目的探讨CTA对巨大盆腹部起源不明肿瘤的定位、定性诊断价值。方法回顾性分析36例盆腹部起源不明巨大肿瘤CTA融合肿瘤图像，结果与手术病理结果进行对照分析。结果CTA显示盆腹部起源不明肿瘤的供血动脉60支，主要供血动脉45支，与手术结果对比，根据肿瘤主要供血动脉对肿瘤定位诊断准确率约为75.0%(27/36)，与常规评价对比，差异有统计学意义。良性肿瘤13例，供血动脉17支，恶性/交界性肿瘤23例，供血动脉43支，恶性肿瘤存在多支血供数量，多于良性肿瘤，但差异无统计学意义，剔除子宫肌瘤数据后，差异有统计学意义。良性肿瘤供血动脉大部分走行规则，侧支供血动脉较少，恶性肿瘤(尤其是囊实性或实性肿瘤)供血动脉常增粗，走行迂曲，侧支供血动脉多而乱。结论CTA显示肿瘤主要供血动脉的来源，提高盆腹部巨大肿瘤术前定位诊断的准确性。肿瘤供血动脉的数量、形态、走行及分布，对良恶性判断诊断有一定价值。

Objective To Investigate and evaluate the clinical value of CT angiography(CTA)in preoper-ative location diagnosis and qualitative diagnosis of large abdominal or pelvic tumors with unknown origin.Methods Totally 36 patients with large abdominal or pelvic unknown origin neoplasm underwent helical CT before surgery.According to the origin,quantity,distribution and arrangement of the feeding arteries,the origin,loca-tion and quality of tumors were diagnosed and compared with operative and pathological findings.Results All of 60 feeding arteries of large abdominal or pelvic tumors with unknown origin were showed,including 45 main feed-ing arteries.The accuracy rate of localization according to the main feeding arteries was 75%(27/36)in comparison with the results of operation.17 feeding arteries were displayed in 13 cases of benign tumor,while 43 feeding arter-ies were displayed in 23 cases of malignant or borderline tumor.There were more feeding arteries for malignant tu-mor than that for benign tumor with no significant differences.It showed significant differences when hysteromyoma was excluded.Most of the feeding arteries of benign tumor were straight and with less collateral arteries,while the feeding arteries of malignant tumor(especially capsule solid or solid tumors)were dilated,tortuous,and with more disordered collateral arteries.Conclusion It improved the accuracy of the localization of large abdominal or pelvic tumor before surgery by observing the origin of main feeding arteries by CTA.It was valuable on qualitative diagnosis of large tumor before surgery according to the number,morphology and distribution of the feeding arteries.