腹膜后周围神经源性肿瘤的超声诊断

Ultrasonographic Diagnosis of Retroperitoneal Periphery Nerve Tumor

目的 分析腹膜后周围神经源性肿瘤的超声诊断特点 ,提高超声定性诊断水平。方法 经手术病理证实的腹膜后周围神经源性肿瘤 2 6例。结果 腹膜后良性周围神经源性肿瘤多位于脊柱旁、肾周 ;形态规则 ,边缘清晰 ,有包膜回声 ;内部以低回声为主 ,可有囊变 ,后方回声增高 ;实质回声欠均匀。超声提示良性神经源性肿瘤 19例 ,诊断总符合率 90 .5 % ( 19/ 2 1) ,其中神经鞘瘤 10 0 % ( 14 / 14 ) ,神经纤维瘤 71.4 % ( 5 / 7)。腹膜后MPNST形态不规则 ,边缘不清晰 ,无包膜 ;瘤体巨大 ;内部回声不均匀 ,以低回声多见 ,后方回声增高 ,可有囊变。超声诊断恶性肿瘤 5例 ,均未提示其来源。结论 腹膜后良性周围神经源性肿瘤超声诊断有一定特异性 ,定性准确率高。腹膜后MPNST ,超声检查仅可判断良恶性 ,而不能进一步提示其来源。

Objective To evaluate the ultrasonographic imaging features of retroperitoneal periphery nerve tumor. Methods The ultrasonographic imaging features of 26 cases were analyzed and compared with the results of pathology. Results The common sites of retroperitoneal benign periphery nerve tumors included spinal roots and the area surrounding kidney. The tumors showed the features as of well-shaped, echogenic capsule, hypoechoic, distal acoustic enhancement and coarse echotexture of the parenchyma, etc. 9 cases had cyst. The accurary of benign nerve tumors was 90.5%(19/21) , schwannoma 100%(14/14),neurfibroma 71.4%(5/7), respectively .The majority of retroperitoneal MPNST was irregular-shaped, inhomogeneous, hypeoechoic, non-echogenic capsule and distal acoustic enhancement,etc. 2 tumors also had cyst. 5 cases were defined as malignant tumors but none of them could be diagnosised as nerve tumors. Conclusion The ulstrasonograhic features of retroperitoneal benign periphery nerve tumors have some characteristic and ulstrasonograhic accuracy was high. As retroperitoneal MPNST as concerned ,the ulstrasonograpy only can distinguish malignant from benign tumor, but it is difficult to distinguish from other malignant soft tissue msses.