节细胞神经瘤的影像学表现  

CT and MR imaging features of ganglioneuroma

作　　者：罗丽 韩福刚 舒健 陈东 刘寒 

机构地区：[1]西南医科大学附属医院放射科,四川泸州646000

出　　处：《实用放射学杂志》2016年第6期849-852,共4页Journal of Practical Radiology

摘　　要：目的 探讨节细胞神经瘤的CT和MR表现。方法 回顾性分析18例经手术病理证实的节细胞神经瘤的CT、MR影像学资料，所有患者均接受CT平扫及增强扫描，2例接受MR平扫。结果 节细胞神经瘤好发于中青年，位于后纵隔8例，肾上腺5例，腹膜后4例，颈部1例。均为单发病灶、边界清楚，嵌入式生长可呈多种形态。CT平扫：12例为均匀低密度，平均CT值22～37 HU；6例密度不均，平均CT值13～46 HU，其中2例伴有坏死、囊变。2例见斑点状钙化。增强扫描：肿瘤各期均无强化4例，仅动脉期轻度强化5例，仅静脉期轻度强化2例，静脉期及延迟期呈轻、中度渐进性强化1例，三期呈渐进性强化6例；坏死及囊变部分未见强化。2例肿瘤内见肋间后动脉穿行，1例见腰动脉穿行并见细小分支滋养肿瘤。2例下腔静脉推挤受压移位，1例见颈部大血管被包绕。MR平扫：1例信号均匀，1例信号不均；T1WI表现为低信号，T2WI呈高信号为主，脂肪抑制（SPIR）及扩散加权成像（DWI）呈高信号。结论 节细胞神经瘤的CT及MR表现具有一定特征性，尤其是CT示肿瘤为均匀低密度、伴有斑点状钙化、肿瘤内血管穿行但未受侵，增强扫描动脉期无明显强化或轻度强化，呈渐进性强化方式，DWI示肿瘤呈高信号时，应考虑节细胞神经瘤的可能。Objective To investigate CT and MR features of ganglioneuroma. Methods CT and MR findings of 18 patients with ganglioneuroma proved by pathology were analyzed retrospectively. Among 18 patients, all of them underwent plain and enhanced CT scanning, while 2 patients underwent plain MR scanning. Results Most ganglioneuroma occurred in middle-aged and young people. Amomg all the 18 lesions, 8 were located in posterior mediastinum,5 in adrenal gland, 4 in retroperitoneum, and 1 in neck. Ganglioneuroma in all 18 cases presented as single lesion with well defined, which showed a tendency of wedging into the space between adjacent organs and structures. Plain CT showed 12 lesions with homogeneous low density with CT values ranged from 22 HU to 37 HU;And 6 with heterogeneous density with CT value ranged from 13 HU to 46 HU. Two cases shwed necrosis and cystic degeneration and two other cases showed spot calcifications. On contrast enhanced CT, 4 cases showed no enhancement, 5 cases showed slight enhancement at arterial phase and 2 cases showed slight enhancement at venous phase, while 1 case showed slight to moderate enhancement at venous and delay phase,and 6 cases showed progressive contrast enhancement at triple-phase. Necrosis and cystic degeneration showed no enhancement. For blood supply, posterior intercostal artery were observed in 2 lesions, lumbar artery in 1 lesion. Inferior caval vein were shoved in 2 cases, and the vessels of neck was surrounded in 1 case. In MR, one showed homogeneous signal, the other showed inhomogeneous signal. The lesions showed hypointensity on T1WI and hyperintensity on T2WI. On SPIR and DWI scanning sequence image, the lesion presented as hyperintensity signal. Conclusion Ganglioneuroma have certain CT and MR features. It should should be considered as possibe diagnosis when a lesion showed homogeneous low density accompanied with spot calcifications, vessels in the lesion with no invasion, no enhancement or slight enhancement, progressive contrast enhancement on enhanced scans, and

关 键 词：节细胞神经瘤 计算机体层成像 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤] R814.42[医药卫生—临床医学]