腹膜后纤维化.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,影像医学部放射科,Outline,Epidemiology,Pathogenesis,Clinical Features,Imaging Features,1,Retroperitoneal Fibrosis,P,roliferation,of aberrant fibroinflammatory,tissue,I,nfrarenal,portion of abdominal aorta,Inferior vena cava,Iliac vessels,R,are condition,:,1.3,per 100,000 population,O,nset,of signs and,symptoms,:,40,65,yrs,Men,:,women,2:1,2,Forms,&,Pathogenesis,Secondary RPF,Drugs,(,12%,),/,N,eoplasms,(,10%,),Idiopathic RPF,2/3,Idiopathic,RPF,P,ericardial fibrosis,S,clerosing,cholangitis,A,utoimmune,pancreatitis,Multifocal fibrosclerosis,IgG4-related disease,3,Soft-tissue mass,:,Well,-,delimited,;,irregular,；,attenuation,similar to psoas muscle,Renal,arteries,-,Iliac vessels,；,U,reters,;,IVC,;,A,orta,Early stages,:,Avid enhancement,Late stages,:,L,ittle,/,absent,enhancement,Hydronephrosis;deep vein thrombosis;renal,vessel involvement,CT,RadioGraphics 2013;33;535552,6,MRI,Active,inflammation,stage,High,T,2,signal,intensity;early enhancement,Late inactive stage,Low,T,2,signal intensity;little/absent,enhancement,Treatment response,Decrease in T,2,signal intensity and enhancement,RadioGraphics 2013;33;535552,7,Idiopathic vs.Malignant lesion,Malignant lesion,Nodular aspect,Mass effect on neighbouring structures,Anterior displacement of aorta and IVC,Idiopathic RPF,Infiltrative aspect,Envelope adjacent structures,Distinction may not hold true in many cases,!,Differentiation between idiopathic and malignant forms,cannot,be made only on the basis of imaging findings.,Rev med Interne.2014 Nov 18,8,10994276;M;46y.o.,9,Idiopathic RPF,Follow-up CT image 6 months later,Rev med Interne.2014 Nov 18,10,In a nut shell,Retroperitoneal Fibrosis,Irregular soft-tissue,mass;,entrapment/compression,of retroperitoneal,structures,Iliac vessels,；,U,reters,;,IVC,;,A,orta,Early,stage,:,high T,2,signal intensity;,avid,enhancement,Late,stage,:,low T,2,signal intensity;,little,enhancement,Idiopathic vs.malignant forms-important but can,not,be made only on the basis of imaging findings,11,