腹膜后良性神经鞘瘤与节细胞神经瘤CT表现的对比研究  

Comparison of Benign Retroperitoneal Schwannomas and Ganglioneuroma on CT

作　　者：张蔚 陆超 刘剑羽[2] 赵殿江[1] 曹沙沙 ZHANG Wei;LU Chao;LIU Jianyu;ZHAO Dianjiang;CAO Shasha(Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学国际医院放射科,北京102206 [2]北京大学第三医院放射科,北京100191

出　　处：《中国医学影像学杂志》2019年第7期491-495,共5页Chinese Journal of Medical Imaging

基　　金：科技部2017国家重点研发计划（2017YFC0113403）

摘　　要：目的分析腹膜后肾上腺外良性神经鞘瘤与节细胞神经瘤的CT表现,探讨CT对两者的鉴别诊断价值。资料与方法回顾性分析经手术病理证实的24例腹膜后肾上腺外良性神经鞘瘤及16例腹膜后肾上腺外节细胞神经瘤患者的临床资料及CT图像特征,并进行组间比较。结果24个神经鞘瘤灶与20个节细胞神经瘤灶在边缘、有无钙化、有无出血、长径、平扫CT值、动静脉期强化差值(ΔCTV-A)等方面差异无统计学意义(P>0.05);两组病灶部位、形态、短长径比、有无囊变坏死、有无包绕大动脉、有无伸入椎间孔、动脉期强化值(ΔCTA)、静脉期强化值(ΔCTV)等比较,差异有统计学意义(P<0.01)。神经鞘瘤病灶共24个,多呈偏侧生长,14个(58%)见于盆腹膜外骶前区,19个(79%)呈圆形或卵圆形,短长径比为0.80±0.14,13个(54%)见囊变坏死,1个(4%)包绕大动脉,11个(46%)伸入椎间孔。节细胞神经瘤病灶共20个,易跨中线生长,8个(40%)见于腹主动脉前/后方,16个(80%)形态不规则,短长径比为0.64±0.16,1个(5%)见囊变坏死,11个(55%)包绕腹腔干等大动脉,1个(5%)伸入椎间孔,强化程度低于神经鞘瘤。结论腹膜后肾上腺外良性神经鞘瘤及节细胞神经瘤的CT表现各具特征,CT增强扫描有助于两者鉴别诊断。Purpose To analyze CT manifestations of benign retroperitoneal extra-adrenal Schwannomas and ganglioneuroma to determine identical and diagnostic value of CT.Materials and Methods Clinical data and CT imaging features of 24 benign retroperitoneal extra-adrenal Schwannomas and 16 retroperitoneal extra-adrenal ganglioneuroma with surgical incision and confirmed by pathology were retrospectively analyzed and compared.Results There was no statistical significance between 24 Schwannoma lesions and 20 ganglioneuroma lesions in terms of margin,calcification,bleeding,long diameter,CT values in plain phase,and enhanced difference between arterial phase and venous phase(ΔCTV-A)(P>0.05).There was statistical significance in lesion location,morphology,short-long diameter ratio,cystoid variation or necrosis,major artery invasion,insertion into the intervertebral foramen,enhanced value in arterial phase(ΔCTA)and enhanced value in venous phase(ΔCTV)(P<0.01).There were totally 24 Schwannoma lesions,most of which were in hemi-growth.14(58%)were seen in anterior region of pelvic extraperitoneal sacral and 19(79%)in the shape of round or oval.The short-long diameter ration was 0.80±0.14.13(54%)were seen with cystic necrosis,1(4%)were evolved around trunk artery,11(46%)invaded intervertebral foramen.There were totally 20 ganglioneuroma lesions,8(40%)were seen in anterior/posterior of abdominal artery and 16(80%)were with irregular morphology.The short-long diameter ration was 0.64±0.16.1(5%)was seen with cystic necrosis and 11(55%)were evolved around coeliac trunk artery.1(5%)invaded intervertebral foramen and the enhancement degree was lower than Schwannoma.Conclusion CT representations of benign retroperitoneal extra-adrenal Schwannomas and ganglioneuroma have their characteristics and enhanced CT examination can help with identificat ion and diagnosis of the two.

关 键 词：神经鞘瘤 腹膜后肿瘤 神经节瘤 体层摄影术 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学] R735.4[医药卫生—诊断学]