肾上腺神经鞘瘤的CT和MR表现  

CT and MRI features of adrenal schwannoma

作　　者：夏丽莹[1] 王传卓[1] 周大昕 唐恋[3] 李飞[4] 孟帆[5] 富聪聪[1] 王亚捷[1] 潘诗农[1] 郭启勇[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004 [2]中国医科大学附属盛京医院超声科,辽宁沈阳110004 [3]沈阳市第四人民医院介入科,辽宁沈阳110004 [4]第四军医大学附属唐都医院放射科,陕西西安710000 [5]河南省肿瘤医院放射科,河南郑州450008

出　　处：《中国医学影像技术》2015年第1期110-114,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81271538);盛京自由研究者基金(201208)

摘　　要：目的探讨肾上腺神经鞘瘤的CT和MR表现。方法回顾性分析12例经手术病理证实的肾上腺神经鞘瘤的临床及影像学资料,所有患者接受CT平扫及增强扫描,4例接受MR平扫及增强扫描。结果 12例肾上腺神经鞘瘤均单发,其中左侧8例,右侧4例,肿瘤体积1.75cm×1.64cm×2.91cm^12.56cm×9.63cm×25.26cm,CT平扫8例为均匀等密度或略低密度,4例密度不均,内有坏死、囊变,其中1例伴少许钙化,平均CT值15~40HU,增强后呈轻至明显强化,实质部分强化均匀,囊性部分无强化。MR平扫示肿瘤在T1WI表现为等或低信号,T2WI为稍高信号,1例肿瘤信号均匀,增强扫描明显均匀强化;3例由于坏死、囊性变信号不均。结论 CT和MRI显示肾上腺区病变具有完整包膜、内部囊性变、出血、钙化及渐进式强化等为肾上腺神经鞘瘤主要影像学特征,可提示肾上腺神经鞘瘤诊断、并为临床诊治提供重要信息。Objective To investigate CT and MR manifestations of adrenal schwannoma.Methods Imaging and clinical data of 12 patients with adrenal schwannoma proved by pathology were retrospectively analyzed.Among 12 patients,all of them underwent plain and enhanced CT scanning,while 4patients underwent both plain and enhanced MR scanning.Results Adrenal schwannoma in all 12 cases presented as single lesion,8cases located in left side,4cases located in right side.The volume of the lesions ranged from 1.75cm×1.64cm×2.91 cm to 12.56cm×9.63cm×25.26 cm.Plain CT showed 8lesions with homogeneous equidensity or slightly low density and 4with heterogeneous density,with calcifications（n=1）and（or）cystic components（n=4）;with CT value ranged from 15 HU to 40 HU.Enhanced CT showed slight or significant enhancement.Substantial part showed homogeneous enhancement,there was no enhancement in the cystic degeneration areas.In MRI,the lesions showed as iso-hypointensity on T1 WI and slightly iso-hyperintensity on T2 WI.After administration of contrast,the lesions obviously and homogeneously enhanced in 1case,while inhomogeneously enhanced in 3cases with cystic degeneration.Conclusion Adrenal schwannoma has characteristic CT and MR manifestations.CT and MRI can clearly demonstrate the intact capsule,cystic degeneration,hemorrhage,calcifications and a characteristic progressive contrast enhancement on dynamic enhanced scans of the adrenal lesions,which can prompt diagnosis of adrenal schwannoma and provide important information for clinical diagnosis and treatment.

关 键 词：肾上腺神经鞘瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R736.6[医药卫生—肿瘤] R445[医药卫生—临床医学]