胸壁神经鞘瘤的CT诊断  

The CT Diagnosis of Chest Wall Schwannoma

作　　者：桑菲 张威威[2] 成官迅[1] SANG Fei;ZHANG Weiwei;CHENG Guanxun(Department of Radiology,Peking University Shenzhen Hospital,Shenzhen,Guangdong Province 518036,P.R.China)

机构地区：[1]北京大学深圳医院医学影像科,深圳518036 [2]北京大学深圳医院超声影像科,深圳518036

出　　处：《临床放射学杂志》2021年第10期1930-1934,共5页Journal of Clinical Radiology

基　　金：深圳市卫健委学科建设能力提升项目(编号:SZXJ2018076)。

摘　　要：目的探讨胸壁神经鞘瘤的CT表现,以提高术前诊断准确率。方法回顾性分析经病理证实的38例胸壁神经鞘瘤患者的临床资料及CT表现。其中男性21例,女性17例;年龄21~62岁,平均(41±13)岁。1例因胸痛入院,6例因胸闷、咳嗽入院,其余均无明显症状偶然发现。22例行CT平扫和增强检查,16例仅行CT平扫检查,对患者的肿瘤部位、数目、大小、形态、边界、密度、强化方式等进行分析。结果38例患者肿瘤均为单发,最大径为1.0~7.2 cm,平均(3.2±1.4)cm。1例呈分叶状,其余均呈类圆形或椭圆形。均位于肋间隙,与胸壁宽基底相连并不同程度凸向胸腔侧生长,边界清晰,无邻近肋骨受侵。38例CT平扫中,11例密度不均匀,余密度均匀。22例CT增强检查中,11例为轻度强化,9例为中度强化,2例为明显强化。38例中,12例出现尾征,27例出现分裂脂肪征。结论胸壁神经鞘瘤具有一定的CT特征,尾征、分裂脂肪征是胸壁神经鞘瘤的特异性征象,CT检查对于胸壁神经鞘瘤的术前诊断有重要提示意义。Objective To investigate the CT features of chest wall schwannoma in order to improve the accuracy of preoperative diagnosis.Methods The clinical data and CT findings of 38 patients with chest wall schwannoma confirmed by pathology were retrospectively analyzed.Among the 38 patients,21 were males and 17 were females;the age of onset was21-62 years old,with an average of(41±13)years old.Most of the patients were asymptomatic,except for 1 patient who was admitted to the hospital due to chest pain and 6 were found in the hospital due to chest tightness and cough,the others were found by accident or abnormal findings by routine chest X-ray and further CT examination.22 cases underwent both CT plain scan and enhanced scan,and 16 cases only underwent CT plain scan.The site,number,size,shape,boundary,density,and enhancement mode of tumors were analyzed.Results The tumors of all patients were solitary,with a maximum diameter of 1.0 cm-7.2 cm,and an average of(3.2±1.4)cm.One of the cases was lobulated,and the rest were round or oval in shape.All of them had smooth edges and located in the intercostal space,connected to the broad substrate of the chest wall and convex to the chest cavity side to varying degrees,without adjacent rib bone invasion.Among the 38 cases,11 cases had uneven density,the rest had uniform density.Among the 22 patients with enhanced CT scan,11 had mild enhancement,9 had moderate enhancement,and 2 had obvious enhancement.Of the 38 cases,12 showed tail sign and 27 had split fatty sign.Conclusion Chest wall schwannomas have certain CT features.Tail sign and fat split sign are specific signs of chest wall schwannoma.CT examination has important implications for the preoperative diagnosis of chest wall schwannoma.

关 键 词：胸壁 神经鞘瘤 体层摄影术 X线计算机 

分 类 号：R734.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]