腹膜后肾上腺外节细胞神经瘤的影像学表现

目的 分析腹膜后节细胞神经瘤的CT和MRI表现,提高其诊断准确率。 方法 回顾性分析50例经手术病理证实的腹膜后肾上腺外节细胞神经瘤的CT、MR资料,并与病理结果对照。50例病例中31例行CT平扫＋增强扫描,35例行MR平扫＋增强扫描,16例同时行 CT和MR扫描。 结果 50例均为单发,47例（94%）边界清楚,肿块最大径平均约9.1±3.8cm,32例（64%）呈伪足样生长方式,18例（36%）呈膨胀性生长方式,21例（42%）例包绕腹部大血管。8例（16%）可见少许囊变,13例（26%）可见钙化,6例（12%）含有脂肪。31例CT平扫均呈等或低密度。T2WI上大多数病例30例（86%）呈不均匀高或稍高信号。强化方式：50例病例中,39例（78%）无明显或轻度强化,11例（22%）呈中度或明显强化,强化病例均呈渐进性延迟强化。强化形态：10例（20%）呈片絮状、线条交织样强化,15例（30%）呈片絮状强化,12例（24%）呈线条交织样强化,3例（6%）呈漩涡状强化。 结论 腹膜后节细胞神经瘤具有一定特征性影像表现,术前CT及MR对于节细胞神经瘤的诊断和评估邻近大血管的关系具有重要价值。

Imaging findings of extra-adrenal retroperitoneal ganglioneuroma

Objective To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of extra-adrenal retroperitoneal ganglioneuroma. Methods CT and MRI data of 50 patients with extra-adrenal retroperitoneal ganglioneuroma in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Dec. 2011 to Aug. 2021 were retrospectively analyzed and compared with the pathological findings. Among the 50 cases, 31 cases underwent CT plain scan and enhanced scan, 35 cases underwent MRI plain scan and enhanced scan, and 16 cases underwent CT and MRI scan at the same time. Results The tumors in 50 patients were all single and 47 (94%) had clear boundary. The average maximum diameter of the mass was (9.1±3.8) cm. Thirty-two (64%) cases showed pseudopodial and embedded growth along the perivascular space and 18 (36%) cases showed expansive growth. Twenty-one (42%) cases surrounded the abdominal great vessels. Eight (16%) cases showed a little cystic change, 13 (26%) cases were accompanied by spotty calcification, and 6 (12%) cases contained patchy fat. Thirty-one cases showed equal or low density on plain CT images. On MRI T2 weighted images, 30 (86%) cases showed uneven high or slightly high signal. Among the 50 cases, 39 (78%) cases had no obvious or mild enhancement and 11 (22%) cases had moderate or obvious enhancement. All enhancement cases showed progressive delayed enhancement. The enhancement patterns were flake flocculent and line interleaving enhancement in 10 (20%) cases, flake flocculent enhancement in 15 (30%) cases, line interleaving enhancement in 12 (24%) cases, and swirl-like enhancement in 3 (6%) cases. Conclusion Extra-adrenal retroperitoneal ganglioneuroma has certain characteristic imaging manifestations. Preoperative CT and MRI are of great value in diagnosing ganglioneuroma and evaluating the relationship between adjacent large vessels.