脊柱外周原始神经外胚层瘤CT、MRI及病理表现  

Spinal Peripheral Primitive Neuroectodermal Tumor:CT,MRI and Pathological Manifestations

作　　者：牛富业[1,2] 马燕青[1] 邹薇薇[1] 徐才国[2] 尹雪军[2] 王晨光[1] 

机构地区：[1]第二军医大学附属上海长征医院影像诊断科 [2]中国人民解放军第413医院放射科

出　　处：《中国医学计算机成像杂志》2015年第2期154-158,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析脊柱外周原始神经外胚层瘤(p PNET)的CT、MRI及病理表现,提高对本病的认识。方法:回顾性分析13例经手术病理证实的p PNET。结果:单发病灶10例,多发病灶3例。11例伴有椎体、附件骨质破坏。8例累及椎管内外,1例脊髓受侵,5例患者可见不典型哑铃征,4例伴有转移。CT平扫为等或低密度,MR平扫T1WI为等或低信号,T2WI为高或混杂高信号;增强扫描明显不均匀强化。病理上光镜下以小圆细胞及HomerWright玫瑰结为特征,免疫组化有两项以上神经源性抗体表达阳性,以CD99为著。结论:p PNET无明显特异性影像学表现,诊断主要靠病理和免疫组化。CT、MRI可以清楚的显示病灶的范围、内部结构及肿块与周围组织的关系,对手术方案的制定具有重要的临床意义。Purpose：To investigate the radiological and pathological characteristics of the vertebral peripheral primitive neuroectodermal tumor（pPNET）,so as to improve the awareness of it.Methods：Thirteen cases of vertebral pPNETs,which were confirmed pathologically with complete data,were analyzed retrospectively.Results：Ten cases were with single lesion,and 3 cases were with multiple lesions.Eleven of 13 cases demonstrated osteolytic destruction;both inside and outside vertebral canal were involved in 8 cases,the spinal cord was compressed;the spinal cord was involved in 1 case;5 cases presented non-typical dumbbell-shaped sign;4 cases were with metastatic lesions.The lesions appeared low or equal density in CT and hypointense or isointense on T1-weighted and hyperintense or mixed intense on T2-weighted imaging.The solid component displayed heterogeneous enhancement in CT and MR enhanced examination.The light microscopic examination results were characterized as small round cells and HomerWright rosettes.Immunohistochemical analysis showed more than two positive neurogenic antibodies,especially the CD99.Conclusion：The radiological features of the pPNET has non-specific,the diagnosis mainly relies on the pathological and immunohistochemical results.CT and MRI can clearly show the lesions,the relationship between internal structure and the surrounding tissues,and have important clinical significance for making operation plan.

关 键 词：原始神经外胚层瘤 X线计算机 体层摄影术 磁共振成像 病理学 

分 类 号：R738.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2