恶性周围神经鞘膜瘤的临床表现及超声特征分析  

Ultrasonic Characters and Clinical Features of Malignant Peripheral Nerve Sheath Tumor

作　　者：陈桂武 谢玉环[1] 刘文芹 廖晓敏 黄彦 卢景新 Chen Guiwu;Xie Yuhuan;Liu Wenqin;Liao Xiaomin;Huang Yan;Lu Jingxin(Department of Ultrasound,Affiliated Dongguan Hospital,Southern Medical University,Dongguan,Guangdong 523000,China;Department of Pathology,Affiliated Dongguan Hospital,Southern Medical University,Dongguan,Guangdong 523000,China)

机构地区：[1]南方医科大学附属东莞医院(东莞市人民医院)超声科,广东省东莞市523000 [2]南方医科大学附属东莞医院(东莞市人民医院)病理科,广东省东莞市523000

出　　处：《中国超声医学杂志》2022年第2期234-237,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析并总结恶性周围神经鞘膜瘤(MPNST)的临床表现,探讨其常规超声表现及超声造影特征。方法回顾性分析20例经病理证实确诊为MPNST患者的临床表现、常规超声及超声造影表现。结果20例MPNST患者的中位年龄为47(36,65)岁,其中男性12例,女性8例。肿块好发于躯干(7例,35.0%)和四肢(6例,30.0%),质地较韧(16例,80.0%),活动度差(19例,95.0%),部分患者可出现感觉异常(12例,60.0%)或活动障碍(2例,10.0%)。常规超声肿块形态规则(9例,45.0%)或不规则(11例,55.0%),边界清(18例,90.0%),内部呈低(10例,50.0%)或混合回声(10例,50.0%),部分可见簇状高回声(7例,35.0%)或无回声区(6例,30.0%)。肿块内部及周边血流分级与大小有关。超声造影肿块呈分支状或分片状快速不均匀增强,内部可见大片状无增强区。结论MPNST超声表现具有一定的特征性,结合临床表现及联合超声造影可进一步提高诊断的准确率。Objective To analyze and summarize the clinical features of malignant peripheral nerve sheath tumor(MPNST),and to explore its conventional ultrasonic characters and contrast-enhanced ultrasonic features.Methods 20 MPNST patients who were pathologically confirmed were included,and analysed the clinical features,the conventional ultrasonic characters and the contrast-enhanced ultrasonic features retrospectively.Results In 20 cases,the median age was 47(36,65)years old,including 12 males and 8 females.The tumor commonly occurred in the trunk(7 cases,35.0%)and limbs(6 cases,30.0%),were tough(16 cases,80.0%)and poor mobility(19 cases,95.0%).Several patients have sensory abnormalities(12 cases,60.0%)or activity disorders(2 cases,10.0%).In the aspect of conventional ultrasound,the masses showed regular(9 cases,45.0%)or irregular(11 cases,55.0%),clear boundary(18 cases,90.0%),low(10 cases,50.0%)or mixed echo(10 cases,50.0%).Clustered hyperecho(7 cases,35.0%)or dark area anecho(6 cases,30.0%)were seen in some masses.The internal and peripheral blood flow were related to the size of the masses.In the aspect of contrast-enhanced ultrasound,the masses showed peripherally enhancingand,rapidly and unevenly,with non-enhancing interior area.Conclusions The ultrasonography of MPNST has certain characteristics,and it is helpful to improve the accuracy of diagnosis combined clinical and contrast-enhanced ultrasonic features.

关 键 词：恶性周围神经鞘膜瘤 临床表现 常规超声 超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R739.43[医药卫生—诊断学]