肢体神经鞘瘤的超声诊断

Sonographic appearances of peripheral nerve sheath tumors of the extremities

目的评价肢体良恶性神经鞘瘤的声像图特点及超声诊断的意义。方法回顾性总结分析经手术病理证实的14例良恶性肢体神经鞘瘤的声像图表现与临床特点。结果良性神经鞘瘤8例,以低回声为主(87.5%),单发,边界清,有包膜,可移动,血流丰富。恶性神经鞘瘤6例,可单发可多发,也以低回声为主(83.3%),但回声不均,边界不清晰且与周围组织有粘连,质地硬,有较丰富的血流。结论良恶性神经鞘瘤声像图有一定特征,超声对于肢体神经鞘瘤的诊断是一种有效的首选方法。

Objective To describe the sonographic appearances of peripheral nerve sheath tumors of the extremities using high-frequency ultrasonography and color Doppler sonography. Methods Fourteen patients with peripheral nerve sheath tumors of the extremities were evaluated retrospectively. Sonography was performed using 7- 10 MHz linear and curved array transducers. Results There were 14 peripheral nerve sheath tumors in our study comprised of eight benign peripheral nerve sheath tumors and six malignant peripheral nerve sheath tumors. With regard to the echogenicity, homogeneity, border appearance and motion, the sonographic characteristics of benign peripheral nerve sheath tumors were mostly hypoechoic （87.5%）, homogeneous, solitary and movable mass with well-defined border appearance and increased vascular signals. However, malignant peripheral nerve sheath tumors were showed solitary or multiple masses with mainly hypoechoic （83.3 % ） echogenicity and inbomogeneous homogeneity. The border appearances were unclear, and the masses were immovably adhesive with surrounding tissues. The vascularity on color Doppler was mild increased on malignant lesion. Conclusion There are some different sonographic appearances between benign and malignant peripheral nerve sheath tumors of the extremities. Sonography may distinguish between benign and malignant peripheral nerve sheath tumors to some extent and is a useful imaging for the diagnosis of peripheral nerve sheath tumors.