良性周围神经鞘肿瘤MRI渐进强化及原因探讨  

The MRI progressive enhancement and cause discussing of benign peripheral nerve sheath tumors

作　　者：杨敏[1] 邹同恩[1] 施崇敏[1] 余江[1] YANG Min;ZOU Tongen;SHI Chongmin;YU Jiang(Department of Medical Imaging Luzhou People＇s Hospital,Luzhou,Sichuan Province 646000,P.R.China)

机构地区：[1]四川省泸州市人民医院医学影像科,四川泸州646000

出　　处：《医学影像学杂志》2018年第5期828-832,共5页Journal of Medical Imaging

摘　　要：目的探讨良性周围神经鞘肿瘤MRI强化模式并结合病理特征分析其形成原因。方法回顾我院经病理证实的10例良性周围神经鞘肿瘤的MRI图像,分析其MRI信号特点及强化模式。结果 10例共12个病灶,其中上肢3个、下肢7个、脊柱旁2个。肿瘤的直径约1.5~36.7cm,平均9.6cm。病灶呈椭圆形3个、圆形3个、不规则形6个。10个病灶T_2WI呈等、高信号,T_1WI呈等、稍低信号;其中2个神经鞘瘤及1个神经纤维瘤病灶呈现靶征,出现率为25.00%;1个上肢神经鞘瘤呈现反靶征,出现率8.33%;2个神经鞘瘤及4个神经纤维瘤病灶呈海礁征,出现率为50.00%;2个神经鞘瘤及2个神经纤维瘤病灶呈现脂肪分离征,出现率33.33%。5个神经鞘瘤及4个神经纤维瘤病灶T_1WI增强扫描表现为渐进强化,出现率为75.00%;其余病灶呈轻度强化或中等度强化,未见明显渐进强化。结论良性周围神经鞘肿瘤黏液基质为主区域呈渐进强化,其原因可能为黏液基质的主要成分黏蛋白形成筛网状结构,导致钆剂通过缓慢。Objective To explore enhancement pattern of benign peripheral nerve sheath tumors and to analyze its cause combining with the pathological characteristics. Methods We retrospectively analyzed MRI imagings of 10 cases of pathology-confirmed benign peripheral nerve sheath tumors and elso analyzed the MRI signal characteristics and enhancement pattern. Results The 10 cases had a total of 12 lesions,of which there were 3 lesions at upper limbs,7 lesions at lower limbs,and 2 lesions adjacent to spine. Tumor diameters were about 1. 5 ~ 36. 7 cm,with a mean of 9. 6 cm. 3 lesions were oval,3 lesions were round,6 lesions were irregular. 10 cases in T_2WI showed intermediate to high signal,and in T_1WI showed slightly low to intermediate signal. Of which,2 schwannomas and 1 neurofibroma showed target sign,and the occurrence rate were 25%; 1 schwannoma at upper limb showed inverse target sign,and the occurrence rate were 8. 33%; 2 schwannomas and 4 neurofibromas showed ocean reef sign,and the occurrence rate were 50%; 2 schwannomas and 2 neurofibromas showed fat split sign,and the occurrence rate were33. 33%. 5 schwannomas and 4 neurofibromas in enhanced scan T_1WI showed progressive enhancement,and the occurrence rate were 75%; the rest of the lesions showed slight enhancement or moderate enhancement,with no obvious progressive enhancement. Conclusion The myxoid matrix region of benign peripheral nerve sheath tumors show progressive enhancement,the reason may be that mucoprotein as the main composition of myxoid matrix,forms many mesh structures and leads to the gadolinium agent passing slowly.

关 键 词：良性周围神经鞘肿瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R738[医药卫生—诊断学]