成人恶性外周神经鞘瘤的CT和MRI表现  

CT and MRI features of malignant peripheral nerve sheath tumor of adults

作　　者：吴红清[1] 宋玲玲[1] 项一宁[2] 朱霞[1] 眭贺[1] 

机构地区：[1]贵州医科大学附属医院影像科,贵州贵阳550004 [2]贵州医科大学附属医院病理科,贵州贵阳550004

出　　处：《中国医学影像技术》2017年第7期1052-1056,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨成人恶性外周神经鞘瘤(MPNST)的CT和MRI表现。方法回顾性分析经过手术病理证实为MPNST 20例患者的CT和MRI表现。结果 20例MPNST位于下肢4例、肩背部及脊柱4例、腹腔内3例、胸壁2例、纵隔2例、乳腺1例、前列腺1例、阴囊1例、头皮1例、左侧上颌窦及眶底1例。20例中,19例为肿块型,1例弥漫型。病灶最大截面约1.41cm×1.42cm^17.10cm×18.08cm。16例边界不清,4例边界尚可。14例CT平扫示病灶呈等、低密度,内部密度欠均匀,2例见多发钙化灶,7例周围骨质呈明显溶骨性破坏;10例CT增强示病灶实质呈中度、明显渐进延迟强化,囊变及坏死区未见明显强化,7例病灶内见纡曲动脉血管影。7例MR平扫示病灶T1WI呈等低信号,T2WI呈混杂高信号,T2WI上囊变区呈明显高信号,3例MRI增强示病灶呈明显不均匀强化,囊变坏死区不强化。1例MR动态增强扫描时间-信号强度曲线呈平台型,DWI呈高信号。结论MPNST的CT及MRI表现具有一定特征性,可提高MPNST的诊断准确率。Objective To explore the CT and MR features of malignant peripheral nerve sheath tumor （MPNST） of adults. Methods The CT and MRI findings of 20 patients of MPNST confirmed by pathology were analyzed retrospectively. Results Among 20 cases, the lesions were located in the lower extremities （n=4）, shoulder and spine （n=4）, abdomen （n=3）, chest wall （n=2）, mediastinum （n=2）, breast （n=1）, prostate （n=1）, scrotum （n=1）, scalp （n=1）, left maxillary sinus and orbital bottom （n=1）. Nineteen cases appeared as solid masses and 1 case appeared as diffuse lesion. The maximum cross section of the lesions were about 1.41 cm×1.42 cm—17.10 cm×18.08 cm. Sixteen cases were ill-defined margin and 4 cases were well-defined margin. CT scan showed 14 cases were lower density or isodensity and with patchy inhomogeneous density. Multiple calcification were found in 2 cases and osteolytic destruction were found in 7 cases. Enhanced CT of 10 cases showed solid component and gradually delayed enhancement, while cystic lesion and necrosis were not enhancement. The tortuous arteries were displayed in 7 cases. Seven cases were performed MRI and the lesions appeared as hypo-intensity on T1WI and hypo-intensity on T2WI with obviously high intensity of cystic component. Enhanced MRI of 3 cases showed significantly heterogeneous enhancement, cyst and necrosis had no enhancement. MR dynamic enhancement of 1 case showed time-signal intensity curve was platform type. DWI showed high signal. Conclusion MPNST has certain CT and MR characteristics which are helpful to improve the diagnostic accuracy.

关 键 词：神经鞘瘤 成年人 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.43[医药卫生—肿瘤] R445[医药卫生—临床医学]