脊柱区良恶性神经鞘瘤的影像表现及鉴别诊断

发布时间：2018-03-14 17:04

本文选题：神经鞘瘤　切入点：恶性外周神经鞘瘤　出处：《临床放射学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨脊柱区良恶性神经鞘瘤的影像表现,以提高对此类肿瘤的认识。方法对21例临床病理确诊的神经鞘瘤和16例恶性外周神经鞘瘤(MPNST)的影像表现进行对比分析并对影像特点采用非参数检验进行统计分析。结果 21例神经鞘瘤和16例MPNST分别位于颈椎(12例,57.1%;9例,56.3%)、胸椎(5例,23.8%;2例,12.5%)和腰骶椎(4例,19%;5例,31.3%);21例神经鞘瘤均伴骨破坏,19例边界清晰,14例伴硬化边形成,19例伴骶孔或椎间孔扩大;16例MPNST中13例伴骨破坏,4例边界清晰,2例伴硬化边,8例伴骶孔或椎间孔扩大;二组肿瘤在边界(χ~2=4.7,P=0.001)、硬化边(χ~2=10.9,P=0.001)、骶孔或椎间孔扩大(χ~2=7.5,P=0.006)存在统计学差异;MRI信号及增强特点无统计学差异(P0.05)。结论神经鞘瘤和MPNST均可伴骨破坏,其骨破坏特点存在一定差异;MRI信号及增强特点相似,对二者的鉴别诊断意义有限。
[Abstract]:Objective to investigate the imaging features of benign and malignant neurilemmoma in spinal area. Methods the imaging features of 21 cases of clinicopathologically diagnosed neurilemmoma and 16 cases of malignant peripheral neurilemmoma were compared and analyzed by non-parametric test. Results 21 cases of neurilemmoma and 16 cases of MPNST were located in cervical vertebrae in 12 cases (57.1%), thoracic vertebrae in 5 cases (23.8%) and lumbosacral foramen in 2 cases (12.5%) and lumbosacral foramen in 4 cases (5 cases), 21 cases of schwannoma of lumbosacral vertebrae (5 cases) with bone destruction, 14 cases with clear border of sclerosis with sclerotic margin and 19 cases with sacral foramen. Or intervertebral foramina enlargement in 16 cases of MPNST 13 cases with bone destruction 4 cases with clear boundary 2 cases with sclerosing side of 8 cases with sacral foramen or intervertebral foramina enlargement; There was no significant difference in MRI signal and enhancement between the two groups (蠂 ~ 2 ~ (2) ~ (4) ~ (7) ~ (7) ~ (7) ~ (th)), sclerosing side (蠂 ~ (210.9) P ~ (0.001)), enlargement of sacral foramen or intervertebral foramen (蠂 ~ (2) ~ (2)), and no significant difference in Mr signal and enhancement. Conclusion both neurilemmoma and MPNST can be accompanied by bone destruction. There are some differences in the characteristics of bone destruction between MRI and MRI, which is of limited significance in differential diagnosis.
【作者单位】：北京大学第三医院放射科;首都医科大学电力教学医院放射科;
【分类号】：R730.44;R738

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