CT及MRI对外周型原始神经外胚层肿瘤的诊断价值  

The diagnostic value of CT and MRI on peripheral primitive neuroectodermal tumors

作　　者：刘江勇[1] 宋佳 曾晓华[1] 黄文才[1] 孙志强[1] 韩立志[1] 赵林[1] 熊晶[1] 

机构地区：[1]广州军区武汉总医院放射影像科,430070 [2]贵州省瓮安县明康医院影像科

出　　处：《中国医师进修杂志》2016年第3期224-228,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨外周型原始神经外胚层肿瘤（pPNET）的影像学表现及其特征，旨在提高对该病的认识及诊断正确率。方法经穿刺或手术病理证实的pPNET患者13例，回顾性分析其CT及MRI特点。4例行单纯CT检查，9例以MRI检查为主，部分病例亦行x线片、CT检查。结果本组病例发病部位较为广泛，2例位于鼻窦，1例位于胸壁，1例位于肺内，3例位于腹盆腔（其中1例盆壁病灶经盆底累及至盆外），1例位于脊柱，5例位于四肢。发生于软组织的8例pPNET表现为单发较大软组织肿块，最大者截面11．2cm×10．6cm。发生于四肢骨关节5例pPNET亦表现较大范围的软组织肿块，其内部信号／密度混杂、明显不均匀强化，骨质破坏显著且呈溶骨性改变，无明显瘤骨及钙化。结论各部位pPNET有其相对影像特征，CT及MRI能显示病灶累及范围、内部结构、有无邻近组织侵犯及远处转移，可为临床治疗及选定方案提供指导性意见，但最终明确诊断依赖于病理及免疫组化检查。Objective To evaluate the imaging performance and characteristics of peripheral primitive neuroectodermal tumors （pPNET）, in order to raise awareness of the disease and the diagnostic accuracy. Methods Thirteen patients with pPNET who confirmed by puncture or pathology were enrolled in this study. The CT and MRI features were retrospectively analyzed. Four patients received simple routine CT examination, and 9 patients had MRI examination based on X-ray, CT examination. Results The part of body involved was more widely.Two patients occurred in the sinuses, 1 patient in the chest wall, 1 patient in the lung, and 3 patients in the abdominal and pelvic（1 patient involved the pelvic floor through the pelvic wall lesions to basins）, 1 patient in the spine, and 5 patients located in the extremities. The characteristics of pPNET by CT and MRI in soft tissue of 8 patients showed single large soft tissue mass, and the biggest was 11.2 cm x 10.6 cm. In bonds and joints of 5 patients, CT and MRI showed wide range of soft tissue mass, mixed internal signal/density with obviously uneven enhancement, significant bone destrnetion and dissolvable osseous changes, and no obvious tumor bone and calcification. Conclusions Each site has its relative imaging characteristics of pPNET. CT and MRI can show lesions involving the scope, internal structure, with or without adjacent tissue invasion and metastasis, and provide guidance for clinical treatment and selecting treatment regimen. But in the end, it depends on the diagnosis of pathological and immunohistochemieal examination.

关 键 词：诊断 体层摄影术 X线计算机 磁共振成像 原始神经外胚层肿瘤 

分 类 号：R739.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2