IDEAL序列在臂丛神经相关肿瘤性病变诊断中的价值  

The value of magnetic resonance IDEAL sequence in the diagnosis of brachial plexus related tumor

作　　者：赵华丽[1] 唐颖 梁宗辉[1] Zhao Huali;Tang Ying;Liang Zonghui(Department of Radiology, Jing＇an Central Hospital, Shanghai 200040, Chin)

机构地区：[1]上海市静安区中心医院放射科,200040 [2]复旦大学附属华山医院放射科

出　　处：《中华手外科杂志》2018年第3期197-201,共5页Chinese Journal of Hand Surgery

基　　金：上海市静安区卫生系统人才培养计划学科带头人（JWRC20141D04）

摘　　要：目的探讨3．0T MRI水脂分离（Iterative decomposition of water and fat with echo asymmetry and least squares estimation,IDEAL）序列对臂丛神经相关肿瘤性病变的诊断价值。方法回顾性分析29例臂丛神经相关肿瘤性病变的MRI表现，观察肿瘤部位、边界、信号特征及其与臂丛神经及周围结构的关系。结果臂丛神经源性肿瘤23例（神经鞘瘤20例，神经纤维瘤病3例），神经鞘瘤边界光整，信号欠均匀，IDEAL序列示神经鞘瘤多为边缘高信号，中央略低信号，主要沿臂丛神经节后段根干部生长（3例跨椎管内外生长），神经位于9中瘤边缘。3例神经纤维瘤病为多发肿瘤，IDEAL序列示肿瘤沿臂丛神经走行跨椎管内外生长，信号不均，臂丛神经包埋。臂丛神经周围相关肿瘤6例，其中孤立性纤维瘤2例，IDEAL序列示肿瘤位于斜角肌下及臂丛神经间隙内，臂丛神经受压推移；脂肪瘤1例，左颈部脂肪信号结节，IDEAL序列示左臂丛上干旁网形低信号光整结节，有包膜；肺癌伴颈根部转移瘤2例，类圆形及分叶状肿块，边界光整，信号均匀，IDEAL序列示臂丛神经受压推移；纵膈恶性神经鞘膜瘤伴臂丛浸润1例，IDEAL序列示左上纵膈异常高信号灶，边界不清，弥漫l生浸润左侧臂丛。结论3．0TMRIIDEAL序列可清晰显示臂丛神经相关肿瘤性病变的部位来源、信号特征及与臂丛和周围结构的关系，为临床诊疗提供可靠信息。Objective To evaluate the value of 3.0T MRI IDEAL sequence in diagnosis of brachial plexus related tumor. Methods The MRI IDEAL manifestations in 29 patients with brachial plexus related tumor were retrospectively analyzed. The location, border, signal characteristics of the tumor and the relationship with brachial plexus and adjacent structures were observed. Results There were 23 cases of neurogenic tumors of the brachial plexus, including 20 cases of neurilemmoma and 3 cases of neurofibromatosis. The neurilemmoma had a smooth boundary with inhomogeneous signal. The IDEAL sequence showed that most of the neurilemmomas were hyperintense on the edge and slightly low in the center. They mainly grow along the course of the postganglionic root of the brachial plexus （3 cases grow inside and outside the spinal canal） and the nerve is located on the edge of the tumor. 3 cases of neurofibromatosis were multiple tumors. The IDEAL sequence showed that the tumor grew along the brachial plexus and crossed the spinal canal. The signal was inhomogeneous, and the brachial plexus was embedded. There were 6 cases of related tumor around the brachial plexus including 2 cases of solitary fibrous tumor. The/DEAL sequence showed the tumor was located in the scalene muscle and brachial plexus gap with brachial plexus compression. There was 1 case of lipoma at left neck. The IDEAL sequence showed a round low signal nodule with a capsule around the upper tnmk of the left brachial plexus, There were 2 cases of lung cancer with neck metastases which was round and lobulated with well-defined margin and homogeneous signal. The IDEAL sequence showed brachial plexus compression. There was 1 case of malignant neurilcmmoma of the mediastinum with brachial plexus infiltration. The IDEAL sequence showed an abnormal high signal focus in the upper left mediastinum. The margin was unclear with diffuse infiltration of the left brachial plexus. Conclusion 3.0T MRI IDEAL sequence can clearly show the location, signal characteristics and the relat

关 键 词：臂丛 肿瘤 诊断 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]