腰大肌神经鞘瘤的CT及MRI诊断价值

目的探讨CT及MRI的影像学特征对腰大肌神经鞘瘤的定性诊断价值。资料与方法收集我院2004年6月至2013年6月经手术病理证实的腰大肌神经鞘瘸11例，其中6例同时行CT及MRI检查，2例仅行CT检查，3例仅行MRI检查。分析肿瘤CT、MRI平扫及增强征象。结果CT平扫：6例肿块为混杂密度：2例为密度均匀的囊性病灶，其中1例邻近椎体有不规则骨质破坏；1例表现为结节样稍高密度。MR平扫：7例为混杂信号，T2WI病灶内见小袭状或斑片状高信号影，2例为囊样病灶。DWI：6例为高低混杂信号改变，其中2例呈“石榴籽”征。CT／MR增强：动脉期，呈结节状、絮状或乳突状强化，向肿瘤中央突入，肿块周围呈环状不均匀强化，门脉期及延迟期呈持续强化，强化范围扩大。结论CT及MRI检查对腰大肌神经鞘瘤有一定的定性诊断价值。

Evaluation of Diagnosis of Schwannoma of Psoas Muscle in CT and MRI

Objective To evaluate the diagnosis of CT and MRI imaging to schwannoma of psoas muscle. Materials andMethods 11 cases of schwannoma of psoas muscle proved by surgery and pathology were admitted in this study. 6 patients underwent CT and MRI examination, 2 cases only a CT scan, 3 patients underwent MRI only. Pre and post contrast CT and MP, I findings of the tumor were analysis. Results 6 cases showed hetero~zeneons density and 2 cystic lesions were homogeneous density, one case was nodular with higher density on CT plain scan. （）ne ot them had irregular vertebra bone desmwtion which adjacent tumor. 7 cases showed heterogeneous si~mal and small cystic lesions or patchy high signal on T2WI of MILl plain scan： 2 cases were cystic lesions. DWI showed heterogeneous signal in six cases, two of them had ＇ Pomegranate Seed＇ sign. The tumors were nodular, flocculent or papillary enhancement and broke into the central in arterial phase, Peripheral tumor showed irregular flower ring enhancement, and progressively enhanced in portal and late phases. Cystic areas were uncertaint,/enhancement. Conclusion CT, MPI scan have certain quali- tative diagmosis of schwannoma of the psoas muscle.