Xu Kaiwei, Chen Yi, Shen Wenqi, Liu Fan, Wu Ruoyu, Ni Jiajing, Wang Linwei, Chen Chunqu, Zhu Lubin, Zhou Weijian, Zhang Jian, Zuo Changjing, Wang Jianhua
Health Science Center, Ningbo University, 818 Fenghua Road, Ningbo, 315211, People's Republic of China.
Department of Radiology, Ningbo Medical Center of Lihuili Hospital of Ningbo University, 57 Xingning Road, Ningbo, 315040, People's Republic of China.
BMC Med Imaging. 2024 Dec 18;24(1):336. doi: 10.1186/s12880-024-01500-4.
Exploring the computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT Multimodal Imaging Characteristics of Desmoplastic Small Round Cell Tumor (DSRCT) to enhance the diagnostic proficiency of this condition.
A retrospective analysis was performed on clinical data and multimodal imaging manifestations (CT, MRI, FDG-PET/CT) of eight cases of DSRCT. These findings were systematically compared with pathological results to succinctly summarize imaging features and elucidate their associations with both clinical and pathological characteristics.
All eight cases within this cohort exhibited abdominal-pelvic masses, comprising six solitary masses and two instances of multiple nodules, except for one case located in the left kidney, the remaining cases lacked a clear organ source. On plain images, seven cases exhibited patchy areas of low density within the masses, four cases showed calcification within the masses. Post-contrast imaging displayed mild-to-moderate, uneven enhancement. Larger masses displayed patchy areas without significant enhancement at the center. In the four MRI examinations, T1-weighted images exhibited uneven, low signal intensity, while T2-weighted images demonstrated uneven high signal intensity. Imaging unveiled four cases of liver metastasis, four cases of ascites, seven cases of lymph node metastasis, three cases of diffuse peritoneal thickening, and one case involving left ureter invasion with obstruction. In the FDG-PET/CT examinations of seven cases, multiple abnormal FDG accumulations were observed in the abdominal cavity, retroperitoneum, pelvis, and liver. One postoperative case revealed a new metastatic focus near the colonic hepatic region. The range of maximum standardized uptake values (SUV) for all lesions are 6.62-11.15.
DSRCT is commonly seen in young men, and the imaging results are mostly multiple lesions with no clear organ source. Other common findings include intratumoral calcification, liver metastasis, ascites, peritoneal metastasis, and retroperitoneal lymph node enlargement. The combined use of CT, MRI and FDG-PET/CT can improve the diagnostic accuracy and treatment evaluation of DSRCT. However, it is imperative to underscore that the definitive diagnosis remains contingent upon pathological examination.
探讨促结缔组织增生性小圆细胞肿瘤（DSRCT）的计算机断层扫描（CT）、磁共振成像（MRI）及氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）/CT多模态成像特征，以提高对此病的诊断水平。
对8例DSRCT患者的临床资料及多模态成像表现（CT、MRI、FDG-PET/CT）进行回顾性分析。将这些结果与病理结果进行系统比较，以简要总结成像特征，并阐明其与临床及病理特征的相关性。
该队列中的8例患者均表现为腹盆腔肿块，其中6例为孤立性肿块，2例为多发结节，除1例位于左肾外，其余病例均无明确的器官来源。平扫时，7例肿块内可见斑片状低密度区，4例肿块内可见钙化。增强扫描显示轻至中度不均匀强化。较大肿块中央可见无明显强化的斑片状区域。在4例MRI检查中，T1加权像呈不均匀低信号，T2加权像呈不均匀高信号。影像学检查发现4例肝转移、4例腹水、7例淋巴结转移、3例弥漫性腹膜增厚及1例累及左输尿管并导致梗阻。在7例患者的FDG-PET/CT检查中，腹腔、腹膜后、盆腔及肝脏可见多处异常FDG摄取。1例术后患者在结肠肝曲附近发现新的转移灶。所有病灶的最大标准化摄取值（SUV）范围为6.62 - 11.15。
DSRCT常见于青年男性，影像学表现多为多发病灶且无明确器官来源。其他常见表现包括肿瘤内钙化、肝转移、腹水、腹膜转移及腹膜后淋巴结肿大。CT、MRI及FDG-PET/CT联合应用可提高DSRCT的诊断准确性及治疗评估。然而，必须强调的是，最终诊断仍取决于病理检查。
