累及臂丛神经的肿瘤MRI诊断(附13例病例报告)

背景与目的：臂丛肿瘤较少见,临床诊断困难。国外有关报道称MRI是诊断臂丛肿瘤的最佳影像学方法,但国内有关这方面的研究较少,本文探讨MRI在臂丛肿瘤诊断中的价值。方法：回顾性分析13例累及臂丛的肿瘤的MRI表现,主要观察肿瘤MRI特征及与臂丛的关系。其中神经纤维瘤病累及臂丛3例,肺上沟瘤侵犯臂丛神经4例,转移瘤侵犯臂丛神经6例,8例经手术病理证实,2例经组织活检证实,3例神经纤维瘤病由临床证实。结果：在3例臂丛神经纤维瘤病中,2例沿臂丛走行生长,呈梭形;1例呈球形,挤压,包绕臂丛;在T1WI上呈中等均匀或不均匀信号,T2WI上为明显高或高低混杂信号,增强后均匀或不均匀强化,4例肺上沟瘤均浸润壁丛祁是经,6例转移瘤中5例表现为局限性肿块包绕,浸润臂丛,1例表现为肿瘤组织弥漫浸润臂丛,肺上沟瘤和转移瘤的MRI表现无特异性,在T1WI上肿瘤均呈等或稍低信号,T2W小为高信号,增强后均匀或不均匀强化。结论：T1WI冠状位可以清晰显示臂丛神经与肿瘤的关系。及臂丛神经受累程度,因此MRI是诊断臂丛神经原发及继发肿瘤的有效影像学手段。

MRI diagnosis of tumor involving brachial plexus

BACKGROUND & OBJECTIVE: The incidence rate of tumor involving brachial plexus was rare and its clinical diagnosis is difficult. Several foreign authors have reported that magnetic resonance imaging (MRI) is the best imaging diagnosis method. Howev, there was little report about this in China. This study was designed to investigate the diagnostic value of MRI in tumor involving brachial plexus. METHODS: The MRI manifestations in 13 patients with tumor involving brachial plexus (including 3 neurofibromatosis, 4 Pancoast's tumor, 6 metastatic tumor; 8 confirmed pathologically, 2 confirmed by biopsy, 3 neurofibromatosis confirmed clinically) were analyzed retrospectively. RESULTS: In 3 patients with neurofibromatosis, 2 cases showed growing along brachial plexus and represented spindle-shape; 1 cases showed growing crushing and encircling brachial plexus and represented ball-shape. There were middle or poor even signals on T1WI, and overt high and high-low mixed signals on T2WI (intense with even or uneven after enhancement). All 4 cases of Pancoast's tumor infiltrated brachial plexus. In 6 cases of metastatic tumor, 5 cases represented that localized bump encircled and infiltrated brachial plexus. 1 case represented that the tumor tissue effusively infiltrate brachial plexus. No special manifestation was shown on MRI of Pancoast's tumor and metastatic tumor. There were the similar or lower signals on T1WI, and high signals on T2WI (intense with even or uneven after enhancement). CONCLUSION: The coronal position of T1WI could clearly represent the relationship between brachial plexus and tumor, the involving extent of brachial plexus. Therefore, MRI is a effective imaging method for diagnosis of primary or secondary tumor involving brachial plexus.