盆腔神经源性肿瘤的CT诊断

CT diagnosis of neurogenic tumors in pelvic cavity

目的探讨盆腔神经源性肿瘤的CT表现及其诊断价值。方法回顾性分析9例经手术病理证实的盆腔神经源性肿瘤的CT表现,其中神经鞘瘤5例,神经纤维瘤4例(1例多发肿瘤)。结果8个单发肿瘤均位于S1～S3前方偏一侧,4例与骶骨广基相连,3例伴同侧骶孔扩大,并见骶孔内软组织影充填。7例平扫密度不均,为低密度与等密度的混杂密度,2例密度均匀与肌肉密度相近,1例神经纤维瘤病肿瘤强化幅度低于肌肉。结论CT扫描有助于盆腔神经源性肿瘤的定位及定性诊断,肿瘤的部位、密度以及与周围组织的关系是有价值的诊断指征。

Objective To investigate the CT findings of neuragenic tumors in pelvic carity. Methods The CT findings of 9 patients with surgically and pathologically proved neumgenic tumors （5 cases of Schwannoma and 4 cases of neurofibroma ） in pelvic cavity were analyzed retrospectively. Only one case of neurofibroma in all patients was multiple tumors. Results Among 8 cases of single tumor, all tumors located on anterior one side of S1 - S3 vertebra, of them, tumors connected broadly with sacrum were found in 4 cases, sacral bore enlargement on same side associated with soft tissue falling in 3 cases. On CT plain images, the density of tumors was nonhomogeneous, i. e. heterogeneous density of hypedense-isodense was found in 7 cases, homogeneous density approaching to that of muscle in 2. Following enhanced CT scans, the enhanced degree of tumor lower than that of muscle was only found in one case of neurofibroma. Conclusion CT scan is helpful to diagnose neurogenic tumors in pelvic cavity while the location and density of the tumor and its relationship with peripheral tissue are the most valuable evidences for diagnosing this disease.