摘要
目的探讨盆腔内神经鞘膜肿瘤CT与MRI表现,提高诊断准确性。方法回顾性分析16例经手术病理证实的盆腔神经鞘膜肿瘤CT与MRI资料,CT 9例(1例只有平扫),MRI 7例(3例有CT)。结果 16例均为单发,位于骶前8例,髂血管区7例,直肠1例,平均最大径约(8.44±4.73)cm。其中7例为神经鞘膜瘤,偏圆形且较小,7例为神经纤维瘤,偏椭圆形且较大,边界清晰,2例为恶性神经鞘瘤,呈椭圆形或不规则形,边界模糊。9例局部边缘与盆壁紧贴塑形,2例骶孔扩大,9例有囊变,2例有钙化,CT平扫为均匀或不均匀低密度,MRI平扫T1WI多呈不均匀低信号,T2WI呈混杂高信号,增强后14例见强化明显与不明显区相互间杂,11例见薄环状强化及12例进行性延时强化。结论盆腔内单发神经鞘膜肿瘤有一定的CT及MRI特征表现,有助于与其它病变鉴别。
Objective To describe the CT and MRI characteristics of nerve sheath tumors of pelvis and to improve the diagnostic accuracy.Methods The CT and MR images of 16 cases with pelvic nerve sheath tumor proved by surgery and pathology were reviewed retrospectively.Among these cases,9cases underwent CT（1case with plain CT only）and 7cases underwent MRI（3cases with CT together）,respectively.Results All 16 tumors were solitary in pelvis,8cases located in the presacral space and 7cases in the iliac vessels,1case in the rectum.The mean tumor maximal axial diameter was（8.44±4.73）cm.Of 16 tumors,7schwannomas were round shape with small size and 7neurofibromas were oval shape with large size and showed a smooth margin.2malignant nerve sheath tumors were irregular or ovoid and had an invasive margin.The local contour of tumors were changed with the shape of the contiguous pelvic wall in 9cases.There were bone destruction of sacral foramina in 2cases,cystic change in 9cases and calcification in 2cases.The plain CT demonstrated homogeneous or heterogeneous lower attenuation.Tumors were shown heterogeneous low signal intensity on T1 WI and high intensity on T2 WI.Enhanced CT and MRI showed the obviously enhancement intermingled with the mild enhancement in 14 cases.11cases presented the thin ring capsule enhancement and 12 cases displayed heterogeneous delayed enhancement.Conclusion The nerve sheath tumors in pelvic have characteristic CT or MRI features,which are helpful for the differential diagnosis.
出处
《医学影像学杂志》
2014年第7期1207-1210,共4页
Journal of Medical Imaging
作者简介
毛俊（1975-），男，硕士，副主任医师，主要从事CT与MR影像诊断工作
