MRI对四肢肿块型血管瘤与外周神经鞘瘤的鉴别诊断

目的探讨MRI对四肢肿块型血管瘤与外周神经鞘瘤的鉴别诊断价值。资料与方法回顾性分析24例四肢肿块型血管瘤患者及53例良性外周神经鞘瘤患者的临床资料,所有患者均行MRI平扫和增强扫描,分析MRI图像,比较肿瘤长径/短径比、部位、MRI特异征象和一般征象。结果血管瘤较外周神经鞘瘤更易发生于下肢(79.2%比50.9%,P=0.019),肿瘤长径/短径比显著大于外周神经鞘瘤(2.01±0.64比1.68±0.59,P=0.007)。外周神经鞘瘤患者发病年龄大于血管瘤[(48.3±14.5)岁比(32.7±16.0)岁,P<0.001]。MRI一般征象中,边缘、囊变、脂肪成分、瘤周包膜和肿瘤强化,两组差异均有统计学意义(P<0.05)。结论与血管瘤相比,外周神经鞘瘤强化更明显,且边缘清晰,更易发生囊变。MRI特异征象与一般征象均有助于四肢肿块型血管瘤和外周神经鞘瘤的术前鉴别诊断。

Differentiation Between Haemangiomas Manifested as Mass Lesion and Peripheral Schwannoma of Extremities by Using MRI

Purpose To investigate the value of differential diagnosis of haemangiomas manifested as mass lesion and peripheral Schwannoma of extremities by MRI.Materials and Methods Data of 24 patients with haemangiomas manifested as mass lesion and 53 patients with peripheral benign Schwannomas confirmed by pathology were retrospectively analyzed.Long/short diameter rate,location,MRI-specific signs and MRI-general signs were analyzed and compared.Results Hemangiomas were more likely to occur in the lower extremities than peripheral Schwannomas(79.2%vs.50.9%,P=0.019),and the long/short diameter rate was significantly larger than that of peripheral Schwannomas(2.01±0.64 vs.1.68±0.59,P=0.007).Patients with peripheral Schwannoma were older than hemangiomas[(48.3±14.5)years vs.(32.7±16.0)years,P<0.001].Among the general MRI signs,the edge,cystic changes,fat components,peritumoral envelope,and tumor enhancement were statistically significant between the two groups(P<0.05).Conclusion Compared with hemangioma,peripheral Schwannomas are more intensive,have clear edges,and are more prone to cystic changes.MRI specific signs and general signs are helpful for the preoperative differential diagnosis of hemangioma and peripheral Schwannoma of extremities.