| 摘要: |
| ［摘要］ 目的 分析恶性周围神经鞘膜瘤（MPNST）的MSCT、MRI及病理学表现，以提高诊断准确性。方法 收集17例经手术病理证实的MPNST，将其MSCT、MRI表现并与病理进行对照分析。结果 17例中，上肢4例，下肢4例，颈背部3例，骶髂关节区3例，椎管内2例，食管1例。肿瘤巨大，瘤内坏死出血常见，钙化较少。MSCT平扫多为等、低混杂密度影，MRI平扫T1WI多呈等、略低信号，T2WI及STIR序列多呈高、低混杂信号，增强扫描瘤体多呈边缘环形明显强化，瘤内实性部分结节状、斑索状不均匀明显强化。病理：肿瘤多呈球形或纺锤形，有假包膜，与神经干粘连，瘤内常坏死、出血，可囊变，钙化少见。镜下肿瘤细胞多形性，以梭形细胞为主；NSE、S-100、CD56、Vimentin标记物多呈阳性。结论 恶性周围神经鞘膜瘤多位于较大神经干走行区。CT、MRI表现与病理成分有较强相关性，结合二者有助于提高诊断与鉴别诊断水平。 |
| 关键词: 神经鞘膜瘤 X线计算机体层摄影术 磁共振成像 病理 |
| DOI：10.3969/j.issn.1674-3806.2014.04.11 |
| 分类号:R 739.4 |
| 基金项目: |
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| Comparative analysis of the manifestations of MSCT and MRI and the pathological features of maligant peripheral nerve sheath tumor: report of 17 cases |
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SUN Pei-yi, WANG Zheng, WEI Xiao-mei
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Department of Radiology, the First Affiliated Hospital of Guangxi Medical University，Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To analyze the maligant peripheral nerve sheath tumors(MPNST)′ MSCT, MRI imaging and pathological features in order to improve its diagnostic accuracy.Methods The retrospective analysis of 17 cases of MPNST confirmed by operation and pathology were performed.Results There were 4 cases in the upper limb, 4 cases in the lower extremity, 3 cases in the neck and back, 3 cases in the sacroiliac joint area, 2 cases in intraspinal area, 1 case in the esophagus. The huge tumor usually showed necrosis and haemorrhage but rare calcification. MSCT scan was mainly manifested as mixed hypodensity and isodensity irregular huge mass shadow, T1WI mainly showed iso-/slight hypo-intensities, T2WI and STIR mostly showed mixed hyper-/hypo-intensities. Contrast enhanced scan showed obvious ringlike enhancement about the edge of tumor and displayed nodous or patchy funicular heterogeneous enhancement of solid component within tumor. Pathology: the tumor had pseudocapsule and mainly showed the ball or spindle form. It showed more haemorrhage necrosis than cystic change and infrequent calcification. The tumor cell showed the varied forms and mainly was the spindle cell. The sensitive makers of the tumor were NSE, S-100, CD56, Vimentin, which showed more positive.Conclusion MPNST often occur in the thick neural stem′s walk line area，there is a strong correlation between the manifestations of MSCT and MRI and the pathological features, The combination of the theirs is helpful in improving the level of diagnosis and differential diagnosis. |
| Key words: Nerve sheath tumors X-ray computed tomography Magnetic resonance imaging Pathology |
