Department of Radiology, Changhai Hospital, The Navy Medical University (Second Military Medical University), 168 Changhai Road, Shanghai, China.
BMC Med Imaging. 2021 Jul 22;21(1):114. doi: 10.1186/s12880-021-00643-y.
The preoperative evaluation is crucial for diagnosis and surgical plan of retroperitoneum ganglioneuroma (GN). In this study, we reviewed a relatively large series of histopathological proved retroperitoneum GN cases, summarized the imaging features and further depicted risk factors of increased surgical blood loss.
A total of 35 (18 male, 17 female) patients were retrospectively enrolled from January 2012 to June 2019 at our institution. Among them, 24 patients had undergone CT scans and 19 patients had undergone MR examination before treatment. The clinical and radiological features were analyzed and the relationships between image features and surgical blood loss were evaluated.
The media age of the involved 35 patients was 40 years (range, 14-66 years). The histological tumor size was 10.12 ± 4.56 cm for average. Retroperitoneum GN was relatively low density on unenhanced CT images and showed delayed progressive enhancement on enhanced CT and MR images. The whorled sign could be seen in 14 patients. The vessel encasement sign could be found in 17 patients. Univariate analysis revealed maximal tumor size measured on axial image, maximal tumor size measured on coronal image, encasing one or both renal pedicles, encasing the aorta and/or vena cava and whorled sign on MRI showed significant difference between the blood loss ≥ 400 ml and blood loss < 400 ml group. Logistic regression further detected that maximal tumor size measured on axial images (OR: 1.12; 95% CI: 1.02-1.24; P = 0.023) and encasing one or both renal pedicles (OR: 22.39; 95% CI: 1.35-372.99; P = 0.030) were independently correlated with surgical blood loss.
Preoperative CT and MR imaging analysis was valuable for both diagnosis and surgical risk prediction of retroperitoneum GN.
术前评估对于诊断和腹膜后神经节瘤（GN）的手术计划至关重要。在本研究中，我们回顾了一组相对较大的经组织病理学证实的腹膜后 GN 病例，总结了影像学特征，并进一步描述了增加手术出血量的危险因素。
本研究回顾性纳入了 2012 年 1 月至 2019 年 6 月在我院接受治疗的 35 例（男 18 例，女 17 例）患者。其中，24 例患者在治疗前接受了 CT 扫描，19 例患者接受了 MR 检查。分析了患者的临床和影像学特征，并评估了图像特征与手术出血量之间的关系。
35 例患者的中位年龄为 40 岁（范围，14-66 岁）。组织学肿瘤大小平均为 10.12±4.56cm。腹膜后 GN 在未增强 CT 图像上呈相对低密度，在增强 CT 和 MR 图像上呈延迟渐进性强化。14 例患者可见漩涡征。17 例患者可见血管包绕征。单因素分析显示，轴位图像上最大肿瘤直径、冠状位图像上最大肿瘤直径、包裹单侧或双侧肾蒂、包裹主动脉和（或）腔静脉、MRI 上的漩涡征在出血量≥400ml 和出血量<400ml 组之间差异有统计学意义。Logistic 回归进一步检测到，轴位图像上最大肿瘤直径（OR：1.12；95%CI：1.02-1.24；P=0.023）和包裹单侧或双侧肾蒂（OR：22.39；95%CI：1.35-372.99；P=0.030）与手术出血量独立相关。
术前 CT 和 MR 成像分析对于腹膜后 GN 的诊断和手术风险预测均具有重要价值。
