纵隔神经源性肿瘤MRI的诊断价值  

Diagnostic value of MRI for mediastinal neurogenic tumors

作　　者：刘文飞[1] 金航[2] 伍建林[1] 于晶[1] 

机构地区：[1]大连大学附属中山医院放射科,辽宁大连116001 [2]复旦大学附属中山医院放射科,上海200000

出　　处：《中国临床医学影像杂志》2017年第2期101-104,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:分析纵隔神经源性肿瘤的MRI平扫信号特点及强化特征,以加强对该病的认识和诊断准确性。方法:经手术病理证实为纵隔神经源性肿瘤33例,分别行MRI自旋回波T_1WI、快速自旋回波T_2WI以及屏气扰相梯度回波T_1WI动态增强扫描,回顾性分析MRI扫描结果。结果:33例纵隔神经源性肿瘤中,神经鞘瘤18例,神经节细胞瘤7例,神经纤维瘤5例,副神经节瘤3例。肿块边界清楚,多呈圆形或椭圆形,MRI扫描T_1WI呈均匀低信号,神经纤维瘤T_2WI呈稍高信号,其余神经源性肿瘤T_2WI多呈不均匀高信号;动态增强扫描神经鞘瘤10例动脉期不均匀轻度强化,静脉期、延时期呈不均匀延时明显强化,3例动脉期不均匀明显强化,静脉期、延时期呈持续性明显强化。神经纤维瘤动脉期均匀轻度强化,静脉期、延时期呈均匀延时明显强化。神经节细胞瘤呈轻、中度延时均匀强化。副神经节瘤动脉期明显不均匀强化,静脉期、延时期呈低强化。结论:纵隔神经源性肿瘤的MRI征象具有一定特点,有助于大多数病例术前正确诊断。Objective： To analyze the characteristics of MRI scan signal for mediastinal neurogenic tumors in order to enhance the understanding and diagnostic accuracy of the disease. Methods： There were 33 cases which were pathologically identified as mediastinal neurogenic tumors. Spin echo T1WI, fast spin echo T2WI, breath spoiled gradient echo T1WI MRI were used and retrospectively analyzed. Results： Among the 33 cases of mediastinal neurogenic tumor, there were 18 cases of neurilemmoma, ganglioneuroma in 7 cases, neurofibroma in 5 cases and 3 cases of paraganglioma. The boundary of the tumors was clear, mostly were round or oval. Through MRI scan, T1WI showed homogeneously low signal; T2WI showed slightly higher signal; the rest of the neurogenic tumors showed inhomogeneously high signal. Through dynamic enhanced scan, 10 cases of neurilemmoma were inhomogeneous slight enhancement in arterial phase and showed inhomogeneous delayed enhancement obviously in venous phase. Three cases of neurilemmoma were inhomogeneous enhancement obviously in arterial phase and showed continuous enhancement obviously in venous phase. Neurofibroma was homogeneous slight enhancement in arterial phase and showed even delayed enhancement obviously in venous phase. Ganglioneuroma showed slight and moderate homogeneous delayed enhancement. Paraganglioma showed inhomogeneous enhancement obviously in arterial phase and low enhancement in venous phase. Conclusion： MRI symptoms of mediastinal neurogenic tumors have some specific characteristics, which could be helpful for the correct diagnosis before operation.

关 键 词：纵隔肿瘤 磁共振成像 

分 类 号：R734.5[医药卫生—肿瘤] R445.2[医药卫生—临床医学]