摘要
目的:探讨周围神经纤维瘤和神经鞘瘤的CT表现共性和特征,提高术前影像诊断的正确率。方法:分析经手术病理证实的全身不同部位周围神经纤维瘤和神经鞘瘤CT资料67例,其中男36例,女31例,年龄17～79岁,中位年龄36岁。多数病人为发现无痛性肿块而就诊,少数病例有胸腹痛及消化道症状。CT检查采用SiemensAR-X扫描仪,层厚和层距5～10mm,其中2例仅行CT平扫,65例行CT平扫+增强扫描。结果:本组病灶分布于头颈、胸腹和四肢,其中单发神经纤维瘤26例,神经鞘瘤37例,恶性神经鞘瘤4例。其共同CT特征为走行于神经干所在部位的圆形、类圆形或半球状肿块,良性者边缘光滑,与周围结构分界清楚(63?67,94%);恶性者呈分叶状或不规则形、与邻近器官界限较模糊(4?67,6%)。其特征性表现在密度变化上,神经纤维瘤多呈均匀软组织密度(20?26,76%),肿块较大者密度稍不均匀(6?26,24%);良性神经鞘瘤呈均匀囊性低密度者6例(6?41,14%),密度不均匀者31例(31?41,76%);4例恶性神经鞘瘤密度明显不均匀:内见不规则形低密度坏死、囊变区或高密度出血灶,与周围组织有粘连,其中2例尚见肿块周围多发肿大淋巴结影(4?41,10%)。结论:掌握不同部位周围神经纤维瘤和神经鞘瘤CT表现的共性和特征,有助于肿瘤的归类诊断和鉴别诊断。
Objective To summarize the CT features of peripheral neurofibroma and neurilemmoma for improving the accurate diagnostic rate. Methods The sixty seven cases of neurofibroma and neurilemmoma confirmed by surgery and pathology were retrospectively studied including malen=36 and femalen=31 aging from 14～79 years old. CT examinations were performed with Siemens AR-X scanner in 5～10mm slice thickness and same intervals. Two cases of 67 patients were only undergone plain scanning the others with the plain plus enhanced examinations. Results In the neurofibromasn=26 the smooth border and the homogenous density were more obvious on plain CT and with homogeneous enhancement on contrast CT. In the neurilemmomasn=41 it easily appeared with the smooth margin but the heterogeneous in density on plain and contrast CT. The larger mass infiltrative growth and irregular enhancement were the important CT signs in malignant neurilemmomas. Conclusions There are common CT features and different CT signs in peripheral neurofibromas and neurilemmomas. These can help us mastering the CT manifestations of peripheral neurogenic tumors.
出处
《中国临床医学影像杂志》
CAS
2004年第12期710-713,共4页
Journal of China Clinic Medical Imaging
