CT及MRI在神经鞘瘤诊治中应用研究

目的观察神经鞘瘤的计算机断层扫描(CT)及磁共振成像(MRI)临床表现,并分析比较两者在该病诊治中的应用价值。方法回顾性分析2009年3月-2014年7月我院肿瘤外科收治的经手术病例证实24例肝门部胆管神经鞘瘤患者临床资料,对所有病例患者手术病理神经鞘瘤患者MRI及CT影像学表现进行分析并比较,并对两种诊断方法的应用价值进行评估。结果 22例为单发病灶,2例有2个病灶,共26个病灶;24个囊实性肿块病灶,2个实性肿块病灶。CT平扫显示可见肝门区或其上方及胰颈部上方呈类圆形、椭圆形或稍低密度肿块,边界清晰,内可见低密度囊性区;MRI扫描可见病灶实性部位T1WI表现稍低或等信号,T2WI表现为等或稍高信号;增强扫描呈不均匀性或进行性延迟强化,坏死囊变区不强化;且CT及MRI均可清晰将病灶周围完整包膜显示出来,且边界清晰;病例检查显示肿块有完整包膜,瘤细胞以梭形为主要特征。结论 CT及MRI在神经鞘瘤中诊断均有较高应用价值,其中肝门部肝管神经鞘瘤有特征性影像学表现,CT及MRI对其均有较好的定位诊断价值,为其临床诊治提供科学理论依据。

Application of CT and MRI in the Diagnosis and Treatment of Schwannoma

Objective To observe the clinical manifestations of computed tomography (CT) and magnetic resonance imaging (MRI) for schwannoma and to analyze and compared the application value of the two in the diagnosis and treatment of the disease.Methods The clinical data of 24 patients with hilar bile duct schwannomaconfirmed by surgery and pathology who were treated in the department of surgical oncology in our hospital between March 2009 and July 2014 were retrospectively analyzed. The manifestations of MRI and CT of patients with surgical and pathological schwannoma were analyzed and compared, and the application value of the two diagnostic methods was evaluated.Results Twenty-two cases were single lesions, 2 cases had 2 lesions, a total of 26 lesions.Twenty-four were cystic solid lesions, and 2 were solid lesions. CT plain scan showed that there was round, oval or slightly low density mass with clear boundaries and low-density cystic areain hepatic hilar region, its upper region and top of the the pancreas;MRI scan showed that the solid part of the lesions manifested slightly lower or equal signal on T1WI andequal or slightly higher signal on T2WI. Enhanced scan showed inhomogeneous or progressive delayed enhancement, and no enhancement in necrotic cystic area. Both of CT and MRI can clearly show the whole surrounding of the lesions, and the boundaries were clear. The cases showed that the tumorswere with complete capsule, and the tumor cells were spindle shaped.Conclusion Both of CT and MRI is of high application value in diagnosis of schwannoma, and the hilar hepatic duct schwannomas are with characteristic imaging features. CT and MRI can better localize and diagnose, providing scientific theory basis for clinical diagnosis and treatment.