MRI诊断肾上腺外副神经节瘤

目的 探讨MRI对肾上腺外副神经节瘤的诊断价值.方法 收集经病理证实的18例肾上腺外副神经节瘤患者,回顾性分析其MRI表现.结果 18例肾上腺外副神经节瘤中,位于颈动脉体6例,颈静脉球4例,腹膜后副神经节2例,膀胱副神经节2例,后纵隔1例,马尾副神经节2例,L2棘突1例,均为单发病灶.全部患者均接受MR平扫及增强扫描,18例肿瘤均明显强化,其中6例颈动脉体瘤及4例颈静脉球瘤内均可见明显流空信号,呈典型的"盐和胡椒征",余肿瘤内均未见明确流空血管.结论 肾上腺外副神经节瘤好发生于头颈部,MRI多具有典型的"盐和胡椒征"表现;也可发生于腹膜后、膀胱、后纵隔、马尾及骨等其他部位,影像学表现常不典型,需与其他肿瘤相鉴别.

MRI diagnosis of extra-adrenal paragangliomas

Objective To investigate the value of MRI in diagnosis of extra-adrenal paragangliomas. Methods Eighteen extra-adrenal paragangliomas proved pathologically were enrolled in this study. MR images were retrospectively reviewed. Results Of the 18 extra-adrenal paragangliomas, 6 located in carotid body, 4 in glomus jugulare, 2 were retroperitoneal paragangliomas, and 2 in bladder, 1 in posterior mediastinum, 2 in filum terminale, 1 in spinous process of L2. All the patients underwent plane and contrast-enhanced MR scan, and all masses showed conspicuous enhancement. "Salt and pepper" appearance was found in the 6 carotid body tumors and 4 glomus jugulare tumors, but not in other tumors. Conclusion Head and neck region is the most common site of extra-adrenal paragangliomas, and often has the characteristic "salt and pepper" appearance on MRI. Paragangliomas can also be found in retroperitoneum, bladder, posterior mediastinum, filum terminale, bone and so on, their imaging manifestations are often atypical and need differentiation from other tumors.