多排螺旋CT在腹膜后神经源性肿瘤的分类及诊断中的价值

发布时间：2018-01-18 11:30

本文关键词：多排螺旋CT在腹膜后神经源性肿瘤的分类及诊断中的价值　出处：《医学影像学杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的探讨腹膜后神经源性肿瘤的CT表现,以加深对其认识,提高术前诊断准确率。方法分析22例经手术病理证实的腹膜后神经源性肿瘤的CT表现特点。并结合文献进行分析、总结腹膜后神经源性肿瘤的影像学特点。全部病例均进行了CT平扫和增强扫描,其中交感神经源性肿瘤5例,神经鞘膜来源肿瘤7例,副节瘤10例。结果 22例腹膜后神经源性肿瘤均位于肾上腺区或沿交感神经链分布,其中交感神经节细胞来源的节细胞神经瘤3例,神经母细胞瘤及神经节神经母细胞瘤各1例;良性神经鞘瘤3例,恶性神经鞘瘤2例,神经纤维瘤2例,嗜铬细胞瘤4例,良性副节瘤4例,恶性副节瘤肿瘤2例。神经母细胞瘤和神经节神经母细胞瘤表现较具有特征性:平扫呈明显低密度,形态不规则,边界尚光整,增强扫描无明显强化或轻微强化;可见有较粗大无规则钙化及腹膜后大血管的包埋征象。副节瘤强化最显著,临床症状及实验室检查具有特征性,神经鞘来源的肿瘤形态差异较大,强化程度介于前两者之间。结论腹膜后神经源性肿瘤根据其好发部位、CT表现,结合患者发病年龄和临床资料,大多数在术前可作出较准确的诊断。
[Abstract]:Objective to investigate the CT findings of retroperitoneal neurogenic tumors in order to better understand them. Methods the CT features of 22 cases of retroperitoneal neurogenic tumors confirmed by surgery and pathology were analyzed. The imaging features of retroperitoneal neurogenic tumors were summarized. All cases underwent plain CT scan and enhanced CT scan, including 5 cases of sympathetic neurogenic tumors and 7 cases of neurilem-derived tumors. Results 22 cases of retroperitoneal neurogenic tumors were located in the adrenal region or along the sympathetic nerve chain, including 3 cases of ganglioneuroma derived from sympathetic ganglion cells. One case of neuroblastoma and one case of ganglioneuroblastoma; There were 3 cases of benign schwannoma, 2 cases of malignant schwannoma, 2 cases of neurofibroma, 4 cases of pheochromocytoma and 4 cases of benign paraganglioma. Neuroblastoma and ganglioneuroblastoma were characterized by low density, irregular morphology and smooth boundary. There was no obvious enhancement or slight enhancement on contrast-enhanced scan. It can be seen that there are coarse irregular calcification and large retroperitoneal great blood vessel embedding signs. The enhancement of paraganglioma is the most obvious clinical symptoms and laboratory examination are characteristic and the tumor morphology of nerve sheath is different. Conclusion most retroperitoneal neurogenic tumors can be accurately diagnosed before operation according to their predilection location CT findings combined with the age of onset and clinical data.
【作者单位】：徐州医学院附属连云港医院影像科;
【分类号】：R735.4;R730.44
【正文快照】： 腹膜后间隙是指后腹壁壁层腹膜与腹横筋膜间解剖间隙的总称,上起自膈肌,下至骶骨岬,两侧向外连于腹膜下筋膜。腹膜后神经源性肿瘤是比较常见的腹膜后肿瘤,在腹膜后肿瘤中居第二位,仅次于间叶组织来源肿瘤,可源于腹膜后任何神经结构,主要位于腹膜后肾上腺区及沿脊柱两侧神经链

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