期刊文献+

脊柱恶性外周神经鞘瘤的CT和MRI表现 被引量:13

CT and MR Manifestations of Malignant Peripheral Nerve Sheath Tumor in Spine
原文传递
导出
摘要 目的分析脊柱恶性外周神经鞘瘤(malignant peripheral nerve sheath tumor,MPNST)的CT和MRI表现,提高术前对该病诊断的准确性。资料与方法回顾性分析12例经病理证实的脊柱MPNST的CT(n=10)和/或MRI(n=11)表现。结果 MPNST表现为类圆形(n=2)或不规则分叶状(n=10)肿块。3例未见明显骨质破坏,9例有邻近椎骨侵犯,主要侵犯神经孔相邻的椎弓根、椎板及相邻局部椎体,骨质破坏以溶骨性骨质破坏(n=8)为主,少数(n=1)为溶骨性骨质破坏与不规则瘤骨同时存在。CT平扫肿块呈等密度(n=4),等、低混杂密度(n=4)或等、高混杂密度(n=2)。MR T2WI和T1WI上均呈以长T2、长T1为主的混杂信号,内部可见片状T2WI高信号(n=8)或点、条状低信号(n=2)或簇状血管影(n=1)。增强扫描肿块多表现为不均匀强化,内部可见不强化坏死区。10例可见神经孔增宽;9例可见肿块与脊神经相连。结论 CT或MRI像上出现神经孔扩大、周围明显骨质破坏、增强扫描不均匀强化、内部有无强化坏死区的脊柱占位性病变,特别是肿块与脊神经相连时应考虑脊柱MPNST可能。 Objective To explore the CT and MRI manifestations of malignant peripheral nerve sheath tumor(MPNST) located in spine and to improve the preoperative diagnostic accuracy.Materials and Methods The CT(n=10) and/or MRI(n=11) data of 12 cases of MPNST proved by pathological results were analyzed retrospectively.Results MPNST manifested as circular(n=2) or irregularly lobulated tumors(n=10).Three cases showed inconspicuous bone destruction and 9 cases showed adjacent vertebrae invasion,in which mainly invaded the pedicle of vertebral arch and vertebral laminae adjacent to the neural foramens as well as vertebral bodies adjacent to tumors.The bone destruction was mainly osteolytic destruction(n=8).Coexistence of osteolytic destruction and irregular tumor bone were seen in one case.The tumors were isodensity(n=4),coexistence of iso/hypo-density(n=4),or iso/hyper-density(n=2) on plain CT imaging.The tumors appeared as hyper-intensity on T2WI and hypo-intensity on T1WI.There were patchy hyper intensity areas(n=8),punctual/stripy hypo-intensity areas(n=2),clustered vessel signals(n=1) in tumors on T2WI.Inhomogeneous enhancement was seen on contrast-enhanced scan in all the cases.Conclusion The imaging features of tumors included enlarged neural foramens,obvious peripheral bone destruction,inhomogeneous enhancement with non enhanced necrotic area,especially connected with spinal nerve,will help to make a diagnosis of malignant peripheral nerve sheath tumor.
出处 《临床放射学杂志》 CSCD 北大核心 2011年第10期1505-1509,共5页 Journal of Clinical Radiology
基金 国家自然科学基金资助项目(编号:30840081)
关键词 神经鞘瘤 恶性 体层摄影术 X线计算机 磁共振成像 Nerve sheath tumor Malignant Tomography X-ray computer Magnetic resonance imaging
  • 相关文献

参考文献14

  • 1Louis DN. The 2007 WHO classification of tumour of the central nerous system. Acta Neuropathol,2007 ,114 :97.
  • 2Carli M, Ferrari A, Mattke A, et al. Pediatric malignant peripheral nerve sheath tumor: the Italian and German soft tissue sarcoma cooperative group. J Clin Oncol,2005,23 : 8422.
  • 3Mehmet DA, Umran Y, Cemal G, et al. Malignant peripheral nerve sheath tumor of the orbit case report and literature review. Skull Base ,2004,14 : 109.
  • 4Robey SS, Dement SH, Eaton KK, et al. Malignant epitheloid peripheral nerve sheath tumor arising in a benign schwannoma. Surg Neurol, 1987,28:441.
  • 5Stark AM, Buhl R, Hugo HH, et al. Malignant Peripheral Nerve Sheath Tumors -report of 8 cases and review of the literature. Acta Neurochirurgica(Wien) ,2001,143:357.
  • 6Minovi A, Basten O, Hunter B, et al. Malignant peripheral nerve sheath tumors of the head and neck:management of 10 cases and literature review. Head Neck,2007,29:439.
  • 7Kim KT, Park YS, Kwon JT, et al. Epub, 2008 Aug 30. Primary paraspinal malignant peripheral nerve sheath tumor. J Korean Neurosurg Soe ,2008,44:91.
  • 8Coleman BG, Arger PH, Dalinka MK, et al. CT of sarcomatous degeneration in neurofibromatosis. A JR, 1983,140:383.
  • 9Murphey MD,Smith WS,Smith SE, et al. Imaging of musculoskeletal neurogenic tumors:radiologic pathologic correlation. RadioGraphics, 1999,19 : 1253.
  • 10Hrehorovich PA, Franke HR, Maximin S, et al. Malignant peripheral nerve sheath tumor. RadioGraphics,2003 ,23 :790.

二级参考文献8

  • 1Dislere DG, Miklicd D. Imaging findings in tumors of the sacrum. AJR, 1999, 173:1699
  • 2Wippold II FJ, Koeller KK, Smimiotoulos JG. Clinical and imaging features of cervical chordoma. AJR, 1999, 172:1423
  • 3江浩.骨与关节MRI[M].上海:上海科学技术出版社,2001.267.
  • 4Breitenseher M,Dominkus M,Scharitzer M,et al.Diagnostic imaging of giant cell tumora.Radiology,2001,41:568
  • 5Aprile I,Scott CA,Cervesato D,et al.Two rare lumbar tumours with unusual MRI characteristics.Neuroradiology,2000,42:458
  • 6刘松龄,张云亭.脊索瘤的病理和影像学表现[J].国外医学(临床放射学分册),2001,24(4):224-227. 被引量:32
  • 7韩月东,杨春敏,赵海涛,刘满生,张学昕,刘凯,葛雅丽,徐长杰.脊索瘤MRI诊断[J].实用放射学杂志,2002,18(2):118-120. 被引量:10
  • 8常恒,王俭,肖湘生.脊柱骨巨细胞瘤的影像学诊断[J].临床放射学杂志,2003,22(1):55-57. 被引量:18

共引文献11

同被引文献98

引证文献13

二级引证文献55

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部