周围神经源性良性肿瘤的超声特性

目的通过分析周围神经源性良性肿瘤的超声特性,评价超声在周围神经源性良性肿瘤中的诊断作用。方法采用回顾性调查方法收集2000—2011年我院收治的有完整临床资料的良性周围神经肿瘤65例患者的术前超声检查、手术图片及病理检查结果,其中58例肿瘤患者同时包含彩色多普勒超声检查结果,由2位有丰富临床经验的超声影像医师对患者的术前超声图像进行回顾分析,评估肿瘤超声特性包括肿瘤的形状、大小、边界、包膜、内部回声特性、后方回声情况与周围神经的关系以及血流情况。结果本组65例良性周围神经源性肿瘤70处病变的超声检查结果显示42处病变(60%)为内部回声均匀的实质性低回声结构;28处病变(40%)为回声不均的低回声结构,其中18处(26%)病变为低回声结构内部可见高回声区,10处(14%)病变为低回声结构内部可见液性暗区;36处病变与知名周围神经相连。58例肿瘤彩色多普勒超声检查显示24例肿瘤(41%)有丰富血流信号,22例肿瘤(38%)有少量血流信号,12例(21%)肿瘤无血流信号。65例患者70处病变均行手术切除,术中见54处病变来源于知名的周围神经,16处病变位于肌肉内,无知名神经纤维连结。超声检查显示病变与神经相连的阳性率为67%(36/54)。65例肿瘤手术切除后病理检查结果显示,62例肿瘤为神经鞘膜瘤,2例为神经纤维瘤,1例为神经纤维瘤病。结论超声检查能提供良性神经源性肿瘤较详细的形态、内部结构、边界、包膜以及肿瘤与周围组织的关系的信息,还能显示肿瘤与周围神经的联系以及血流情况等,检查方便易行,检查费用低廉,患者易于接受。

Analysis of sonographic features of benign peripheral nerve tumors

Objective To evaluate the sonographic features of benign peripheral nerve tumors. Methods Snnographic, operative and pathologie results of 65 patients with benign perlpheral nerve tumors were stmfied retrospectively, and sonographic features of the tumors including the shape, margins, capsule, internal echogenicity, posterior acoustic enhancement, nerve involvement, and vascularity were analyzed. Results There were sixty-five patients with 70 lesions. Sonographic examination showed that 42 lesions were homogeneous hypoechoic, eighteen lesions het- erogeneous hypoechoic with central hyperechoie region, and 10 lesions heterogeneous hypoechoic with anechoic fluidfilled area. The continuity of the tumor with the peripheral nerve was detected in 36 lesions. Color Doppler examinations performed on 58 cases showed that 12 cases had no blood flow within the tumors, twenty-two cases small amount of blood flow, and 24 cases copious blood flow. Operative findings showed that 54 lesions were arising from named peripheral nerves. The pathologic diagnoses were neurilemrnomas in 62 cases, neurofibromas in 2 cases, and neurofibromatosis in 1 case. Conclusion Ultrasound can provide more detailed benign neurogenic tumors shape, internal structure, boundaries, envelope and the relationship between the tumor and surrounding tissue of the information, but also to show the link between tumor and peripheral nerve and blood flow, etc. Its cheek convenient and easy check inexpensive, easy accepted by patients.