中轴区原发外周型原始神经外胚层肿瘤CT和MRI表现

发布时间：2018-05-09 19:14

本文选题：外周型原始神经外胚层肿瘤 + 中轴区　；参考：《中国骨伤》2016年03期

【摘要】：目的 :探讨中轴区原发外周型原始神经外胚层肿瘤(p PNETs)的CT和MRI表现,以提高对中轴区原发p PNETs的影像学认识。方法 :回顾性分析2008年10月至2014年5月期间经病理证实的10例中轴区原发p PNETs患者临床资料,其中男7例,女3例;年龄8~49岁,中位年龄23.6岁。术前经多排螺旋CT平扫3例,平扫并增强4例;5例经MRI平扫并增强扫描;其中2例同时行CT及MRI检查。结果 :骨内型6例,骨外型4例。发病部位及例数分别为骶椎3例,腰椎2例,颈椎1例,颈椎椎管1例,尾骨1例,右髂骨1例,骶前间隙1例。横断位最小肿瘤最大层面大小1.1 cm×1.2 cm,最大者8.0 cm×9.2 cm,中位大小4.4 cm×5.7 cm,其中6例最大径线5 cm。其中溶骨性破坏5例,2例伴钙化,混合性1例,2例无骨质破坏。CT以等密度为主,1例密度均匀,余6例密度不均,其中3例可见"浮冰"样改变,增强扫描1例中度强化,余3例明显强化,2例内见多发小血管。MRI在T1WI上5例均为等信号,在T2WI上均为稍高信号,信号不均,增强后5例均强化明显。2例伴椎体压缩性骨折,10例均未见骨膜反应,5例MRI检查无椎间盘破坏。结论:中轴区原发p PNETs以儿童及青年多见,肿块常较大。骨内型肿块常包绕椎体,并以椎前间隙为主,均伴椎体骨质破坏,溶骨性常见,椎体原发多见,附件原发或受累少见,可累及椎管,以前壁受累常见,可伴多发新生小血管;骨外型以深部软组织间隙常见,少数原发于椎管,多伴椎体骨质破坏,以溶骨性为主。不侵及椎间盘,椎间隙不窄。CT可伴"浮冰"征,以骨内型常见。MRI T1WI以等信号为主,T2WI以稍长信号为主,增强强化明显。
[Abstract]:Objective: To investigate the CT and MRI manifestations of primary peripheral primitive neuroectoderm tumor (P PNETs) in the middle axis in order to improve the imaging knowledge of primary P PNETs in the middle axis. Methods: retrospective analysis of 10 cases of primary P PNETs patients in the middle axis from October 2008 to May 2014, including 7 males, 3 females, and age 8~49 years. The median age of 23.6 years was 23.6. 3 cases underwent multislice spiral CT plain scan before operation, 4 cases were plain scan and enhanced, 5 cases underwent MRI plain scan and enhanced scan. 2 cases underwent simultaneous CT and MRI examination. Results: 6 cases of internal bone and 4 cases of external bone. The incidence area and number were 3 of sacral vertebrae, 1 cases of lumbar vertebra, 1 cases of cervical vertebra, 1 cases of right iliac bone, 4 cases of right iliac bone, and sacral space. The maximum size of the smallest tumor was 1.1 cm x 1.2 cm, the largest was 8 cm x 9.2 cm, the median size was 4.4 cm x 5.7 cm, of which 6 cases were 5 cm., including 5 with osteolytic destruction, 2 cases with calcification, 1 cases of mixed sex, and 2 cases without bone destruction.CT. Enhanced scan 1 cases of moderate enhancement, 3 cases of obvious enhancement, 2 cases of multiple small vascular.MRI in 5 cases of T1WI were equal signals, on the T2WI were slightly high signal, signal uneven, 5 cases were enhanced obviously.2 cases with vertebral compression fracture, 10 cases did not have periosteum reaction, 5 cases of MRI examination without disc destruction. Conclusion: primary P PNETs in the middle axis region. The intraosseous mass is often large. The intraosseous mass is often wrapped around the vertebral body, mainly with the anterior intervertebral space, with the vertebral bone destruction, the bone dissolution is common, the vertebral body is common, the vertebral body is common, the appendage primary or the involvement is rare, it can involve the spinal canal, the anterior wall is frequently involved, and the new small blood vessels are often accompanied by the deep soft tissue space and a few original. In the vertebral canal, most of the vertebral bodies are associated with bone destruction, mainly with bone dissolution. The intervertebral disc is not invaded and the intervertebral space is not narrow.CT can be accompanied by "ice floe" sign, and the common.MRI T1WI in the intraosseous type is the same signal, and the T2WI is a slightly longer signal, strengthening and strengthening obviously.

【作者单位】：宁波大学医学院附属医院;第二军医大学附属长征医院;
【分类号】：R739.4

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