肝门部神经鞘瘤CT、MRI表现与病理对照分析

目的 探讨肝门部神经鞘瘤的CT、MRI表现,提高对该病的认识和诊断水平.资料与方法 回顾性分析经手术病理证实的6例肝门部神经鞘瘤患者的临床、CT、MRI资料,其中2例行CT、MRI检查,3例行CT检查,1例行MRI检查,分析其CT、MRI表现特征并与病理结果对照.结果 肝门部神经鞘瘤的MRI表现:T_1WI序列表现为低或等信号,T_2WI序列为等、高信号.CT表现:CT平扫表现为等密度或稍低密度、边界清晰的肿块,其内可见散在小片状低密度坏死区.CT、MRI增强呈延迟强化或不均匀强化.CT、MRI可见病灶周围有完整包膜,边界清晰.病理以瘤细胞呈梭形、外见完整纤维包膜为特征,免疫组织化学S-100、NSE、Vimentin阳性.结论 肝门部神经鞘瘤具有特征性CT、MRI表现,CT、MRI对肝门部神经鞘瘤的诊断及鉴别诊断具有重要价值.

The CT, MRI Features and Pathology of Portal Neurinoma

Objective To explore CT and MRI features of portal neurinoma,and to improve the diagnosis and the understanding of the disease.Materials and Methods The CT and MRI features of 6 patients with portal neurinoma proved by surgery and pathology were reviewed retrospectively.Two patients received both CT and MRI pre and post-contrast scan,3 patients received CT scan,and 1 patient received MRI scan.The CT,MRI features were analyzed and compared with pathological findings.Results MRI features of portal neurinoma were low or iso-signal on T_1WI and high or iso-signal on T_2WI.CT features included well-defined mass with iso-attenuation or hypo-attenuation on CT plain scanning and delayed or asymmetrical enhancement on CT contrast imagings.Complete envelopes were displayed on CT and MRI images.Fusiform neoplastic cell and complete envelope were the distinctive pathological features.S-100,NSE(neuron-specific enolase),Vimentin were positive.Conclusion CT and MRI features of portal neurinoma are characteristic.CT and MRI are valuable in the diagnosis and differential diagnosis of portal neurinoma.