胸、腹部恶性神经鞘瘤的CT表现

目的回顾分析胸、腹部恶性神经鞘瘤的CT表现,以提高对本病的认识。方法胸部5例,腹部4例,手术7例,CT引导下经皮穿刺2例,均经病理证实。结果肿瘤位于纵隔5例,腹壁2例,腹膜后2例;孤立性肿块7例,弥漫性2例(位于纵隔);伴胸水4例,伴椎体成骨性转移1例。CT平扫:7例孤立性肿块,呈圆形或椭圆形,中心出现大面积低密度区,CT值5~20HU,6例包膜完整。2例弥漫性病变则呈均匀的密度。注入对比剂后,7例孤立性肿块实质部分及2例弥漫性病变出现不同程度强化。结论CT诊断胸腹部恶性神经鞘瘤孤立性肿块者,具有一定特点,但弥漫性肿块则无特点。

CT Appearances of Thoracic and Abdominal Malignant Neurilemoma

Objective To analyse CT appearances of malignant neurilemoma in the thorax and abdomen,in order to improve the diagnostic accuracy of this disorder. Methods There were 9 cases(5 cases in thorax and 4 cases in abdomen) with malignant neurilemoma proved by pathology (7 cases by surgery and 2 cases by CT guided percutaneous puncture biopsy). CT both plain and enhanced scans were performed in all cases. Results Tumors were located in the mediastinum in 5, in abdominal wall and retroperitoneum in 2 respectively .7 cases were isolated masses,2cases were disseminated masses,in company with pleuritic fluid was in 4 and with osteogenic metastasis of vertabral body in one case.The isolated masses appeared as round or ellipse with low density in the centre,the CT value was 5~20 HU,6 cases had complete capsule.The disseminated masses in 2 cases appeared as homogeneous density.On contrast-enhanced scan,the solid parts of masses were enhanced in different degree. Conclusion The isolated thoracic and abdominal malignant neurilemoma is of certain CT characteristics, but the disseminated one is not.