腹膜后间隙神经鞘瘤的320排CT征象及病理基础

发布时间：2018-06-26 02:15

本文选题：神经鞘瘤 + 腹膜后　；参考：《临床放射学杂志》2017年09期

【摘要】：目的分析腹膜后间隙神经鞘瘤的320排CT表现及与病理的关系,探讨320排CT对其诊断和鉴别诊断价值。方法回顾性分析22例经手术病理证实的腹膜后间隙神经鞘瘤的320排CT表现及病理结果。术前均行320排CT平扫与三期增强检查。结果 (1)22例中,良性神经鞘瘤19例,恶性神经鞘瘤3例,盆部腹膜外间隙3例,腹腔腹膜后间隙19例。(2)CT表现,完全囊变型7例,囊实性型12例,完全实性型3例;良性肿块边缘光整,境界清楚,恶性肿块局部边界模糊;所有肿块实性部分呈渐进性延迟轻中度强化,平扫、增强动脉期、门静脉期、延迟期CT值分别(35.40±7.70)HU、(45.09±8.71)HU、(56.27±10.33)HU、(68.64±12.68)HU;术前定位准确度100%,定性准确度90.90%(20/22)。(3)病理表现,镜下,肿瘤内可见Antoni A区和Antoni B区两种组织类型,Antoni A区细胞密集排列,Antoni B区细胞稀少,细胞间有较多液体存在,常伴各种退行性变。结论腹膜后间隙神经鞘瘤的320排CT表现有特征性,CT表现取决于细胞稀疏区与密集区的比例和排列方式,囊实性多见,呈渐进性延迟轻中度强化,边界清楚,CT对腹膜后神经鞘瘤的定位定性诊断具有重要价值。
[Abstract]:Objective to investigate the value of 320 slice CT in diagnosis and differential diagnosis of retroperitoneal space neurilemmoma. Methods the CT findings of 320 slices of 22 cases of retroperitoneal space neurilemmoma confirmed by operation and pathology were retrospectively analyzed. All patients underwent 320-slice CT plain scan and 3-phase enhancement before operation. Results (1) among the 22 cases, 19 were benign neurilemmoma, 3 malignant schwannoma, 3 pelvic extraperitoneal space and 19 retroperitoneal space. (2) CT findings showed complete cystic variant in 7 cases, cystic solid type in 12 cases and complete solid type in 3 cases. The margin of benign mass is smooth, the boundary is clear, the local boundary of malignant mass is blurred, all solid parts of the mass are gradually delayed, mild to moderate enhancement, plain scan, enhanced arterial phase, portal vein phase, The CT values of delayed phase were (35.40 卤7.70) HU, (45.09 卤8.71) HU, (56.27 卤10.33) HU, (68.64 卤12.68) HU.Preoperation localization accuracy was 100, qualitative accuracy was 90.90% (20 / 22). (3) pathological findings. Under microscope, there were few cells in Antoni A region and Antoni B region in tumor. It is often accompanied by various degenerative changes. Conclusion the 320 slice CT findings of retroperitoneal space neurilemmoma are characterized by the proportion and arrangement of the sparse and dense areas of the cells. The cystic and solid features are more common with progressive delay of mild and moderate enhancement. Ct has important value in the diagnosis of retroperitoneal neurilemmoma.
【作者单位】：福建医科大学附属第一医院影像科;
【分类号】：R730.44;R735.4

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