颈部神经鞘瘤的CT表现与病理对照

目的 :探讨颈部神经鞘瘤的CT表现及其与病理学之间的关系 ,了解其CT表现的病理学基础。方法 :回顾性分析经手术、病理证实的颈部神经鞘瘤 3 6例 ,增强扫描 2 7例 ,并与手术病理结果进行比较。结果 :CT平扫表现为均匀等密度、略低密度 (和颈部肌肉相比 )肿块 12例 ,增强扫描呈轻度均匀强化 ;2 4例平扫表现为不均匀等密度、略低密度肿块 ,伴中心点状、片状更低密度区 ,增强扫描肿块呈轻度至明显强化 ,中央更低密度区无明显强化。上述表现与病理对照显示更低密度区由疏细胞区 (AntoniB区 )、陈旧性出血及囊性变组成 ,等密度、略低密度区由富细胞区 (AntoniA区 )和胶原组成。不同的细胞区域构成形成不同的CT表现 ,增强表现与AntoniA区增强有关。结论 :颈部神经鞘瘤的CT表现与其病理改变有关 ,对正确诊断具有指导意义。

Correlative study of CT features and pathologic findings in cervical neurilemmoma

Objective:To study the CT features of cervical neurilemmoma in correlation with pathology and to investigate the pathologic basis of CT findings.Methods:Thirty-six patients with cervical neurilemmoma proved by operation and pathology were investigated.Of these patients,27 were scanned with enhancement.The manifestations of CT scans were correlated with the findings of pathology.Results:12 of 36 cervical neurilemmomas appeared as homogeneous isodense or slightly hypodense spindle-form masses with slightly homogeneous enhancement;24 of 36 appeared as spindle-form heterogeneous isodense or slightly hypodense masses with punctiform or patchy more hypodense areas.After enhancement,the masses enhanced slightly to obviously with no enhancement of the central areas.All of these CT manifestations correlated well to pathology of cervical neurilemmoma.The area of very low density corresponded to the area of Antoni B,old bleeding, and cystic changes.Area of Antoni A and collagen were attributed to iso-density or slightly low density.Different cell distribution showed different CT image.There was a close relationship between Antoni A area and enhancement.Conclusion:The CT manifestations of cervical neurilemmoma are closely related to pathologic changes,and this has great significance for guiding to the correct diagnosis.