坐骨直肠窝恶性外周神经鞘膜瘤1例并文献复习  

Malignant peripheral nerve sheath tumor in the ischiorectal fossa:a case report and literature review

作　　者：高博聪 袁涛[1] 全冠民[1] GAO Bocong;YUAN Tao;QUAN Guanmin(Department of Medical Imaging,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,Chin.)

机构地区：[1]河北医科大学第二医院医学影像科,石家庄050000

出　　处：《国际医学放射学杂志》2024年第1期116-119,共4页International Journal of Medical Radiology

摘　　要：目的探讨坐骨直肠窝恶性外周神经鞘膜瘤(MPNST)的影像学特点,以提高对该肿瘤的认识。方法回顾性分析1例经病理证实的坐骨直肠窝MPNST病人的CT和MRI表现,并复习相关文献。结果肿瘤为囊实性袋状肿物,部分边界不清,CT平扫呈等-低密度,增强扫描呈不均匀渐进性强化。MRI平扫时T_(1)WI呈等信号、T_(2)WI呈靶状高低混杂信号;扩散加权成像(DWI)呈局部点片状高信号,表观扩散系数(ADC)图呈低信号;增强扫描表现为颗粒状、片絮状,呈不均匀渐进性强化,动态增强曲线为平台型。结论MPNST是坐骨直肠窝的罕见肿瘤,其影像表现具有一定特点,认识特殊征象(不典型“靶征”、“神经出入征”)及动态强化方式有利于诊断。Objective Aiming to investigate the imaging features of malignant peripheral nerve sheath tumors(MPNST)in the ischiorectal fossa to enhance comprehension of this tumor.Methods The CT and MRI manifestations of a pathologically confirmed case of MPNST in the left IRF were retrospectively analyzed,and a comprehensive review of relevant literature was conducted.Results The tumor presented as a cystic solid,bag-like mass with unclear boundaries.CT revealed iso-to hypo-attenuation on pre-contrast scan,and heterogeneous and progressive enhancement after contrast medium injection.T_(1)WI showed iso-intensity compared to muscle,while T_(2)WI exhibited a target-like mixed hyper-and hypo-intensity.Diffusion-weighted imaging(DWI)displayed local patchy hyper-intensity,while the apparent diffusion coefficient(ADC)image exhibited hypo-intensity.MR examination after contrast medium injection showed granular,patchy,and heterogeneous and progressive enhancement,with a plateau-type time-intensity curve.Conclusion MPNST is a rare tumor in the IRF,and its imaging manifestations display characteristic features.A comprehensive understanding of typical signs such as“target sign”,“entering or exiting nerve sign”,and the dynamic enhancement modes is helpful in making a diagnosis.

关 键 词：恶性外周神经鞘膜瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学]