成人恶性外周神经鞘瘤的CT和MRI表现

发布时间：2018-04-25 05:08

本文选题：神经鞘瘤 + 成年人　；参考：《中国医学影像技术》2017年07期

【摘要】：目的探讨成人恶性外周神经鞘瘤(MPNST)的CT和MRI表现。方法回顾性分析经过手术病理证实为MPNST 20例患者的CT和MRI表现。结果 20例MPNST位于下肢4例、肩背部及脊柱4例、腹腔内3例、胸壁2例、纵隔2例、乳腺1例、前列腺1例、阴囊1例、头皮1例、左侧上颌窦及眶底1例。20例中,19例为肿块型,1例弥漫型。病灶最大截面约1.41cm×1.42cm~17.10cm×18.08cm。16例边界不清,4例边界尚可。14例CT平扫示病灶呈等、低密度,内部密度欠均匀,2例见多发钙化灶,7例周围骨质呈明显溶骨性破坏;10例CT增强示病灶实质呈中度、明显渐进延迟强化,囊变及坏死区未见明显强化,7例病灶内见纡曲动脉血管影。7例MR平扫示病灶T1WI呈等低信号,T2WI呈混杂高信号,T2WI上囊变区呈明显高信号,3例MRI增强示病灶呈明显不均匀强化,囊变坏死区不强化。1例MR动态增强扫描时间-信号强度曲线呈平台型,DWI呈高信号。结论MPNST的CT及MRI表现具有一定特征性,可提高MPNST的诊断准确率。
[Abstract]:Objective to investigate the CT and MRI findings of malignant peripheral neurilemmoma in adults. Methods CT and MRI findings of 20 cases of MPNST proved by operation and pathology were analyzed retrospectively. Results 20 cases of MPNST were located in lower limbs in 4 cases, shoulder, back and spine in 4 cases, abdominal cavity in 3 cases, chest wall in 2 cases, mediastinum in 2 cases, mammary gland in 1 case, prostate in 1 case, scrotum in 1 case, scalp in 1 case. Left maxillary sinus and orbital floor in 1 case. Of 20 cases, 19 cases were mass type and 1 case diffuse type. The maximum cross section of the lesion was about 1.41cm 脳 1.42cm~17.10cm 脳 18.08cm.16. In 4 cases, the boundary of the lesion was not clear. In 14 cases, CT plain scan showed that the lesion was isotropic, low density and uneven internal density. In 2 cases, multiple calcification lesions were found in 7 cases with apparent osteolytic destruction in 7 cases. In 10 cases, CT enhancement showed that the lesion was moderate in substance. Obviously gradual delay enhancement, There was no obvious enhancement in the cystic and necrotic areas in 7 cases. In 7 cases of the lesions, the tortuous artery was seen in 7 cases. Mr plain scan showed that the lesions were isohypointential on T _ 2WI and mixed with high signal intensity on T _ 2WI. In 3 cases, the lesions were enhanced inhomogeneously on MRI enhancement in 3 cases, and on T _ 2WI in 3 cases. The time-intensity curve of dynamic contrast-enhanced Mr scan showed high signal intensity on the platform type of DWI without enhancement of the dead zone of cystic degeneration in 1 cases. Conclusion CT and MRI findings of MPNST are characteristic and can improve the diagnostic accuracy of MPNST.
【作者单位】：贵州医科大学附属医院影像科;贵州医科大学附属医院病理科;
【分类号】：R445.2;R730.44;R739.4

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