外周原始神经外胚层肿瘤的CT、MRI表现及其病理基础  

CT and MRI findings and pathological characteristics of peripheral primitive neuroectodermal tumor

作　　者：罗显丽 杨晓荣 金开元 王凤 李邦国 LUO Xianli;YANG Xiaorong;JIN Kaiyuan;WANG Feng;LI Bangguo(Department of Radiology,the Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou Prooince 563003,China;Department of Pathology,the Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou Prooince 563003,China)

机构地区：[1]遵义医科大学附属医院放射科,贵州遵义563003 [2]遵义医科大学附属医院病理科,贵州遵义563003

出　　处：《实用放射学杂志》2021年第1期107-111,共5页Journal of Practical Radiology

摘　　要：目的分析外周原始神经外胚层肿瘤(pPNET)的CT、MRI表现及其相关病理基础,提高对本病的认识及影像诊断水平.方法回顾性分析经病理证实的27例pPNET的CT和MRI表现,并与病理结果进行对照.结果24例行CT检查,其中12例同时行增强检查;10例行MRI检查,其中8例同时行增强检查.27例病变均为单发病灶,20例发生于软组织(6例位于胸部,副鼻窦及鼻腔、椎管、四肢软组织各3例,肩部2例,腰背部、颈部及肾上腺各1例);7例发生于骨(4例位于骨盆,肩胛骨、下颌骨及颅骨各1例).软组织pPNET主要表现为较大不规则或分叶状软组织肿块,边界不清,可伴邻近骨质破坏(n=11)及骨膜反应(n=2).CT平扫肿瘤呈等或稍低密度,MRI呈等或稍长T1、等或混杂长T2信号,密度或信号不均匀,可伴囊变、坏死(n=13)、出血(n=6)及分隔(n=6),罕见钙化(n=1),增强扫描呈不均匀中重度持续强化,其中6例动脉期见迂曲细小供血动脉.骨pPNET大部分表现为骨髓腔溶骨性、膨胀性骨质破坏伴明显软组织肿块,未见骨膜反应、肿瘤骨及钙化灶.结论pPNET的CT及MRI表现无特异性,CT及MRI在显示肿瘤的位置、大小、内部结构及与周围组织结构的关系、明确肿瘤有无复发及转移等方面有重要价值.Ohjective To analyze CT and MRI findings and pathological characteristics of peripheral primitive neuroectodermaltumor(pPNET),to improve understanding and diagnostic ability of these tumors.Methods CT and MRl findings of 27 patients withpPNET confirmed by histopathologicy were analyzed retrospectively,and compared with pathological resultsResults 24 cases underwentCT examination,and 12 of them underwent enhanced scan simultaneously.10 cases underwent MRI,and 8 of them underwent bothplain and enhanced scan.All of the 27 pPNET cases were solitary.20 cases occurred in the soft tssues,including chest(n=6),paranasalsinus and nasal cavity(n=3),spinal canal(n=3),limbs(n=3),shoulder(n=2),lumbar back(n=1),neck(n=1),and adrenalgland(n=1).7 cases occurrd in bone,including pelvis(n=4),scapula(n=1),mandible(n=1),and skull(n=1).The pPNET occurredin soft tissue mainly manifested as large irregular or lobulated mass with ill-defined boundary,and was accompanied with adjacentbone destruction(n=11)and periosteal reaction(n=2).The tumors often appeared isodense or slightly hypodense on unenhancedCT images,isointensity or slightly hypointensity on T1WI,and isointensity or heterogencous hyperintensity on T1WI.The tumorstended to be heterogeneous with necrosis,cystic(n=13),hemorrhage(n=6),internal separations(n=6),and rare calcification(n=1).The enhanced images showed that the tumors were moderate to significant and continual enhancement with tiny feeding arteries inthe arterial phase(n=6).The pPNET arising from bone demonstrated expansive and lytic bony destruction in marrow cavity withlarge soft tissue mass without periosteum reaction,neoplastic bone formation and calcification.Conclusion Although CT and MRI findings of pPNET are not specific,the two imaging modalities are valuable in depicting and evaluating the lesion loxation,size,internalstructures,the relationship with adjacent tissue,and the tumor recurrence and metastasis.

关 键 词：原始神经外胚层肿瘤 计算机体层成像 磁共振成像 病理学 

分 类 号：R730.264[医药卫生—肿瘤] R814.42[医药卫生—临床医学]