腹膜后节细胞神经瘤的少见征象:误诊病例分析  

Atypical imaging appearance of retroperitoneal ganglioneuroma

作　　者：杨盼盼 龚姝卉 尹伟 弓静 YANG Pan-pan;GONG Shu-hui;YIN Wei;GONG Jing(Department of Radiology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院影像医学科,上海200433

出　　处：《影像诊断与介入放射学》2022年第3期188-193,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨腹膜后节细胞神经瘤(GN)影像学误诊原因,提高术前影像诊断水平。方法回顾性分析54例经手术病理证实的腹膜后GN的CT、MR资料,采用卡方检验、独立样本t检验及Mann-Whitney U检验对术前诊断正确组和误诊组之间的影像学特征进行比较。结果术前影像诊断正确25例(46%),误诊29例(54%)。9例误诊为神经鞘瘤,6例误诊为间叶源性恶性肿瘤,6例误诊为淋巴瘤或肿大淋巴结,3例误诊为副神经节瘤,3例误诊为淋巴管瘤,2例误诊为脂肪类肿瘤(1例脂肪瘤,1例脂肪肉瘤)。伪足征(P=0.023)、线条交织征(P=0.033)、强化程度(P=0.007)及强化形态(P=0.049)在诊断正确组和误诊组之间可见统计学差异。肿瘤大小、形状、T_(2)WI信号、CT平扫、动脉期强化值(ΔCTA)、静脉期强化值(ΔCTV)、囊变、钙化、脂肪成分、包绕大血管、伸入椎间孔、漩涡征在两组之间未见明显统计学差异(P均>0.05)。结论通过分析腹膜后GN的影像误诊原因,了解其不典型征象,有助于避免术前误诊。Objective To investigate the cause of misdiagnosis of retroperitoneal ganglioneuromas(GN)on imaging.Methods CT and MRI of 54 patients with pathologically confirmed retroperitoneal GN were analyzed retrospectively.Imaging characteristics between the correctly and incorrectly diagnosed groups were compared using chi-square test,independent sample t-test and Mann-Whitney U test.Results 29 retroperitoneal GN(54%)were misdiagnosed as schwannomas(9),mesenchyma derived malignant tumors(6),lymphomas(6),paragangliomas(3),lymphangiomas(3),lipoma(1),and liposarcoma(1).Presence of pseudofoot sign(P=0.023),interweaving line sign(P=0.033),degree of contrast enhancement(P=0.007),and enhancement pattern(P=0.049)were significantly different between the correctly and incorrectly diagnosed groups.There was no significant difference between the two groups(P>0.05)in tumor size,shape,cystic degeneration,calcification,fat component,T_(2) signal intensities,CT values on plain scan and changes in arterial and venous phases,vascular encasement,and foraminal extension.Conclusion Misdiagnosis of retroperitoneal GN can be mitigated by understanding the atypical imaging appearance.

关 键 词：节神经细胞瘤 腹膜后 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.4[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R445.2