外周神经源性肿瘤的MRI表现与鉴别诊断  

MRI appearances and differential diagnosis of peripheral neurogenic tumor

作　　者：金腾[1] 吴刚[1] 李小明[1] 王仁法[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2014年第10期1213-1216,共4页Radiologic Practice

基　　金：国家自然科学基金资助项目(81320108013;31170899;81071133)

摘　　要：目的:探讨外周神经源性肿瘤的磁共振表现,旨在提高对该类疾病的影像学诊断水平。方法:回顾性分析经手术病理证实的外周神经源性肿瘤21例,其中神经纤维瘤14例,神经鞘瘤6例,恶性蝾螈瘤1例。所有神经源性肿瘤患者行MRI扫描。结果:4例神经纤维瘤表现为"葡萄藤"状,10例神经纤维瘤为分叶状,6例神经鞘瘤表现为梭形或类圆形肿块,恶性蝾螈瘤为团块状。神经纤维瘤MR均表现为T1WI等信号,T2WI以高信号为主,其中夹杂低信号分隔;神经鞘瘤T1WI呈稍低信号,T2WI表现为低信号周边环绕高信号即"靶征";恶性蝾螈瘤在T2WI上表现为高信号,其内可见环形或线样低信号分隔影。结论:外周神经源性肿瘤发生的部位、形状、大小以及信号特点均对其MRI诊断有帮助。Objective：To evaluate the MR imaging manifestations of peripheral neurogenic tumor,in order to improve the standard of diagnosis.Methods：MR imaging features of 21 patients with surgery and pathology proven peripheral neuro-genic tumor were retrospectively analyzed,there were 14 neurofibromas,six schwannomas and one malignant triton tumor. All patients underwent MRI scanning routinely.Results：Of the 14 patients with neurofibroma,grapevine-like appearance was showed in 4 patients and lobulation in 10 patients.Fusiform or ovoid mass were assessed in the 6 patients with schwan-noma.The malignant triton tumor was showed as a mass.The neurofibromas showed isointensity （compared with adjacent muscle）on T1 WI,mainly hyperintensity yet mixed with some hypo-intensity septa on T2 WI.Schwannoma showed slight hypo-intensity on T1 WI and target like appearance with central hypo-intensity surrounded with a hyper-intensity rim on T2 WI.The malignant triton tumor showed high signal intensity mixed with annular or linear low signal intensity septation on T2 WI.Conclusion：The location,morphology,size、and signal intensities of peripheral neurogenic tumors varied,which can provide helpful information for the MRI diagnosis.

关 键 词：周围神经系统肿瘤 磁共振成像 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.43[医药卫生—诊断学]