腹膜后神经鞘瘤的超声特征  

Sonographic features of retroperitoneal schwannoma

作　　者：杨帆[1] 黄晓娟[1] 刘静媛 陈媛[1] 吴火林 雷建美 YANG Fan;HUANG Xiaojuan;LIU Jingyuan;CHEN Yuan;WU Huolin;LEI Jianmei(Department of Ultrasound,the 907th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force,Nanping 353000,China)

机构地区：[1]中国人民解放军联勤保障部队第907医院超声科,福建南平353000

出　　处：《中国中西医结合影像学杂志》2022年第2期172-175,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：南平市自然科学基金联合资助项目(2019J30)。

摘　　要：目的:探讨腹膜后神经鞘瘤(RS)的超声表现。方法:回顾性分析经手术和病理证实的15例RS和52例浅表神经鞘瘤(SS)的超声表现,并比较两者的超声特征。结果:15例RS均为单发病灶,12例位于腹部腹膜后、脊柱旁,其中10例位于脊柱与肾脏之间、腰大肌前方;3例位于盆部腹膜后,其中2例位于骶前间隙、骶孔前方,1例位于右侧坐骨神经走行区。超声示RS实性3个,囊实性9个,囊性3个。RS的主要超声表现:形态规则(86.7%)、边界清晰(93.3%)、内部囊变(80.0%)、血流信号不丰富(66.7%)、未显示钙化(86.7%)、未见靶征(93.3%)、未见受累神经(93.3%)。52例SS共56个病灶,其中位于头颈部10个,上肢13个,下肢20个,躯干9个,腋窝4个。SS的主要超声表现:形态规则(78.6%)、边界清晰(98.2%)、血流信号丰富(80.4%)、受累神经可见(53.6%)、无内部囊变(76.8%)、未见钙化(98.2%)、未见靶征(55.4%)。相较于SS,RS的肿瘤体积更大,内部囊变、血流信号不丰富更常见,靶征及受累神经更少见(均P<0.05)。结论:RS常发生各种肿瘤变性,是导致其超声特征不同于SS的主要原因。Objective:To investigate the sonographic features of retroperitoneal schwannoma(RS).Methods:Ultrasonic appearances of 15 patients with RS and 52 patients with superficial schwannoma(SS)confirmed by surgery and pathology were analyzed retrospectively and compared.Results:All 15 cases of RS were of single focal lesion.Among them,12 lesions were paraspinally situated in abdominal retroperitoneum,with 10 lesions between the spinal column and kidney,in front of psoas major muscle;three lesions were present pelvic retroperitoneum,with two in presacral space,anterior to the sacral foramen,and one in right sciatic nerve region.Ultrasonography showed there were 3 lesions displaying as solid tumors,9 as cystic and solid ones,and 3 as cystic ones.Ultrasonic appearances of most RS in this group included regular morphology(86.7%),clear boundary(93.3%),internal cystic degeneration(80.0%),poor blood flow signals(66.7%),no calcification(86.7%),no target sign(93.3%)and no detected affected nerve(93.3%).52 cases with SS had 56 lesions,and 10 lesions were located in head and neck,13 in upper limbs,20 in lower limbs,9 in trunk,4 in armpit.Ultrasonic appearances of most SS in this group were as follows:regular morphology(78.6%),clear boundary(98.2%),abundant blood flow signals(80.4%),visible affected nerves(53.6%),no visible internal cystic degeneration(76.8%),no calcification(98.2%)and no target signs(55.4%).Compared with SS,RS had larger tumor volume,more common internal cystic degeneration and poor blood flow signals,but target signs and affected nerves were less common(P<0.05).Conclusion:The fact that RS often undergo various tumor degenerations is the main reason why the sonographic features differ from those of SS.

关 键 词：神经鞘瘤 腹膜后肿瘤 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.4[医药卫生—诊断学]