腹膜后肾上腺外节细胞神经瘤的影像学表现  

Imaging findings of extra-adrenal retroperitoneal ganglioneuroma

作　　者：龚姝卉 杨盼盼[1] 尹伟[1] 张倩雯 高依莎 弓静[1] 钟婧娇 GONG Shu-hui;YANG Pan-pan;YIN Wei;ZHANG Qian-wen;GAO Yi-sha;GONG Jing;ZHONG Jing-jiao(Department of Radiology,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Radiology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Pathology,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)第一附属医院影像医学科,上海200433 [2]上海中医药大学附属曙光医院影像医学科,上海201203 [3]海军军医大学(第二军医大学)第一附属医院病理科,上海200433

出　　处：《海军军医大学学报》2023年第2期251-255,共5页Academic Journal of Naval Medical University

基　　金：海军军医大学(第二军医大学)第一附属医院“234学科攀峰计划”(2020YPT001)。

摘　　要：目的 分析腹膜后肾上腺外节细胞神经瘤的CT和MRI表现。方法 回顾性分析2011年12月至2021年8月海军军医大学(第二军医大学)第一附属医院收治的50例腹膜后肾上腺外节细胞神经瘤患者的CT、MRI检查资料,并与病理结果对照。50例病例中31例行CT平扫+增强检查,35例行MRI平扫+增强检查,16例同时行CT和MRI检查。结果 50例患者肿瘤均为单发;47例(94%)肿瘤边界清楚;肿块平均最大径为(9.1±3.8)cm;32例(64%)沿血管周围间隙呈伪足样、嵌入式生长,18例(36%)呈膨胀性生长;21例(42%)肿瘤包绕腹部大血管;8例(16%)肿瘤内部可见少许囊变,13例(26%)可见少量斑点状钙化,6例(12%)含有斑片状脂肪成分。31例病灶CT平扫均呈等或低密度。MRI T2加权成像上30例(86%)病灶呈不均匀高或稍高信号。50例患者中39例(78%)病灶无强化或轻度强化,11例(22%)呈中度或明显强化,强化特点为渐进性延迟强化。10例(20%)病灶呈片絮状、线条交织样强化,15例(30%)呈片絮状强化,12例(24%)呈线条交织样强化,3例(6%)呈漩涡状强化。结论 腹膜后肾上腺外节细胞神经瘤具有一定特征性影像学表现,术前CT和MRI对于节细胞神经瘤的诊断和评估及其与邻近大血管的关系有重要价值。Objective To analyze the computed tomography(CT) and magnetic resonance imaging(MRI) findings of extra-adrenal retroperitoneal ganglioneuroma. Methods CT and MRI data of 50 patients with extra-adrenal retroperitoneal ganglioneuroma in The First Affiliated Hospital of Naval Medical University(Second Military Medical University) from Dec.2011 to Aug. 2021 were retrospectively analyzed and compared with the pathological findings. Among the 50 cases, 31 cases underwent CT plain scan and enhanced scan, 35 cases underwent MRI plain scan and enhanced scan, and 16 cases underwent CT and MRI scan at the same time. Results The tumors in 50 patients were all single and 47(94%) had clear boundary.The average maximum diameter of the mass was(9.1±3.8) cm. Thirty-two(64%) cases showed pseudopodial and embedded growth along the perivascular space and 18(36%) cases showed expansive growth. Twenty-one(42%) cases surrounded the abdominal great vessels. Eight(16%) cases showed a little cystic change, 13(26%) cases were accompanied by spotty calcification, and 6(12%) cases contained patchy fat. Thirty-one cases showed equal or low density on plain CT images. On MRI T2 weighted images, 30(86%) cases showed uneven high or slightly high signal. Among the 50 cases, 39(78%) cases had no obvious or mild enhancement and 11(22%) cases had moderate or obvious enhancement. All enhancement cases showed progressive delayed enhancement. The enhancement patterns were flake flocculent and line interleaving enhancement in 10(20%) cases, flake flocculent enhancement in 15(30%) cases, line interleaving enhancement in 12(24%) cases, and swirl-like enhancement in 3(6%) cases. Conclusion Extra-adrenal retroperitoneal ganglioneuroma has certain characteristic imaging manifestations. Preoperative CT and MRI are of great value in diagnosing ganglioneuroma and evaluating the relationship between adjacent large vessels.

关 键 词：节细胞神经瘤 腹膜后肿瘤 肾上腺外肿瘤 X线计算机体层摄影术 磁共振成像 

分 类 号：R739.44[医药卫生—肿瘤]