超声对不同软组织层次浅表神经鞘瘤诊断准确性的差异性分析  

Difference Analysis of Ultrasound in the Diagnosis of Superficial Schwannomas at Different Soft Tissue Levels

作　　者：刘勋[1] 陈霰[1] Liu Xun;Chen Xian(Department of Ultrasound,Tianjin Fifth Central Hospital,Tianjin 300450, China)

机构地区：[1]天津市第五中心医院超声科

出　　处：《中国超声医学杂志》2019年第7期647-649,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析浅筋膜层与肌层神经鞘瘤的超声图像特征,比较二者超声诊断准确性的差异性。方法回顾分析在我院超声检查且最终病理证实的患者55例神经鞘瘤二维超声影像学特征,其中浅筋膜层22例,肌层33例,将超声诊断提示与病理结果对照分析,对不同软组织层次超声诊断准确性进行分析。结果 55例患者术前超声提示神经鞘瘤者34例,准确性约61.8%(34/55),其中头颈部10例,胸背部6例,上肢18例,下肢21例;回顾分析发现神经鞘瘤超声图像表现为低回声(55/55)、有包膜(55/55)、边界清晰(55/55)、部分伴囊性变(20/55)、部分伴有鼠尾征(25/55)。其中肌层内33例术前超声提示30例,与病理结果对照准确性90.9%(30/33),皮下浅筋膜层内22例术前超声提示者4例,与病理结果对照准确性约18.2%(4/22),肌层间隙内神经鞘瘤诊断准确性明显高于浅筋膜层,差异具有统计学意义(P<0.001)。发生囊性变者20例,均位于肌层内,超声诊断准确性60.6%(20/33),出现鼠尾征者30例,均位于肌层内,超声诊断准确性90.9%(30/33)。结论超声对于浅表周围神经鞘瘤诊断有较高准确性,尤其对于肌层间隙神经来源者为著;肌层内出现鼠尾征及囊性变对于诊断神经鞘瘤有很高的诊断价值。Objective The ultrasonographic features of superficial fascia and muscular schwannoma were analyzed.The differences of accuracy in the ultrasound diagnosis were compared.Methods The two-dimensional ultrasound imaging features of 55 cases of schwannomas were analyzed retrospectively.The cases were confirmed by ultrasonography and final pathology in our hospital,including 22 within superficial fascia and 33 within muscular layer.Comparison of ultrasound diagnostic results with pathological results,we analyze the accuracy of ultrasound diagnosis within different soft tissue levels.Results Preoperative ultrasound examination results indicated 34 cases of schwannoma with an accuracy of 61.8%(34/55),including 10 cases of head and neck,6 cases of chest and back,18 cases of upper limbs and 21 cases of lower limbs.Retrospective analysis revealed that ultrasonographic features of schwannoma were hypoechoic(55/55),capsular(55/55),clearly defined(55/55),partly cystic degeneration(20/55),and partly with mouse tail sign(25/55).Among them,preoperative ultrasound examination in 33 cases showed an accuracy of90.9%(30/33)compared with those of pathological results.Preoperative ultrasound in 22 cases showed an accuracy of about 18.2%(4/22)compared with those of pathological results.The diagnostic accuracy of schwannoma in the intermuscular space was significantly higher than that in the superficial fascia.The difference was statistically significant(P<0.001).The 20 cases of cystic degeneration were located in the muscular layer.The accuracy of ultrasonic diagnosis was 60.6%(20/33).The 30 cases with mouse tail sign were located in the muscular layer,and the accuracy of ultrasound diagnosis was 90.9%(30/33).Conclusions The ultrasound has a high accuracy rate for the diagnosis of superficial peripheral schwannomas,especially for those with muscular schwannoma.The features of rat tail and cystic changes in the muscular layer have the high diagnostic value for the diagnosis of schwannomas.

关 键 词：超声 软组织层次 浅表 神经鞘瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]