腹膜后恶性外周神经鞘膜瘤的CT特征与临床病理分析  

CT features and clinicopathological analysis of retroperitoneal malignant peripheral nerve sheath tumor

作　　者：孙永灿 钱国珍 张铭 李文杰 张恩龙 SUN Yongcan;QIAN Guozhen;ZHANG Ming;LI Wenjie;ZHANG Enlong(Department of Radiology,Peking University International Hospital,Beijing 102206,China;Department of Pathology,Peking University International Hospital,Beijing 102206,China;Department of Retroperitoneal Tumor Surgery,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院放射科,北京102206 [2]北京大学国际医院病理科,北京102206 [3]北京大学国际医院腹膜后肿瘤外科,北京102206

出　　处：《实用放射学杂志》2023年第3期413-415,427,共4页Journal of Practical Radiology

基　　金：北京大学国际医院院内科研基金项目(YN2019 QN03)。

摘　　要：目的探讨CT对腹膜后恶性外周神经鞘膜瘤(MPNST)的诊断价值。方法回顾性分析经病理确诊的10例腹膜后MPNST患者的临床和CT资料。1例行CT平扫,9例行CT平扫及增强。结果肿瘤最大径平均(15.8±7.5)cm。8例单发,2例多发。8例表现为不规则形,2例为类圆形。CT平扫表现为等或低密度,实性5例,囊实性5例。4例见钙化。增强扫描肿瘤实性部分动脉期呈不均匀轻度至明显强化,呈斑片状、岛屿状强化,静脉期呈渐进性强化。结论腹膜后MPNST多表现为单发体积较大病灶,形态不规则,侵犯范围广,常伴有囊变、坏死及钙化,CT增强扫描实性部分呈不均匀渐进性强化,有助于诊断。Objective To evaluate the value of CT in diagnosis of retroperitoneal malignant peripheral nerve sheath tumor(MPNST).Methods The clinical and CT data of 10 patients with pathologically confirmed retroperitoneal MPNST were analyzed retrospectively.1 patient underwent unenhanced CT scan,and 9 patients underwent unenhanced and enhanced CT scans.Results The average maximum diameter of the tumor was(15.8±7.5)cm.8 cases were single and 2 cases were multiple.8 cases showed irregular shape and 2 cases were oval.Unenhanced CT scan showed equal or low density,5 cases were solid and 5 cases were cystic and solid.Calcification were observed in 4 cases.On enhanced scanning,the solid part of the tumor showed uneven patchy and island like mild to obvious enhancement in arterial phase,and progressive enhancement in venous phase.Conclusion Retroperitoneal MPNST is presenting as a large single mass with irregular shape and wide range of invasion,often accompanied by cystic degeneration,necrosis and calcification.The solid part of enhanced CT shows uneven progressive enhancement,which is helpful for the diagnosis.

关 键 词：恶性外周神经鞘膜瘤 腹膜后肿瘤 计算机体层成像 

分 类 号：R730.264[医药卫生—肿瘤] R735.5[医药卫生—临床医学] R814.42