节细胞神经瘤的CT表现及病理分析

CT findings and pathologic analysis of ganglioneuromas

目的探讨节细胞神经瘤的CT平扫与动态增强扫描的特征性表现。方法回顾性分析10例经手术与病理证实节细胞神经瘤的CT表现,所有病例均行CT平扫,动脉期、静脉期及延迟期动态增强扫描。结果肿块位于纵隔7例,肾上腺2例,腹膜后1例。肿块边界清晰,呈椭圆形2例,不规则形8例,肿块大小为1.2cm×2.2cm×3.0cm～6.5cm×6.5cm×7.5cm,4例肿块有嵌入性生长特点。CT平扫肿块密度低于肌肉,密度均匀者9例,密度不均匀者1例,其中3例伴有颗粒状、条状钙化。增强扫描后,肿块表现为不同的强化型式,其中,1例肿块无强化;7例肿块动脉期无明显强化,静脉期及延迟期逐渐轻度强化;2例肿块动脉期轻度强化,静脉期及延迟期逐渐明显强化。结论节细胞神经瘤有一些特征性影像表现及强化型式,CT动态增强扫描有助于其诊断及鉴别诊断,可清晰显示病变同周围血管及器官之间的关系,并为手术治疗提供更多参考信息。

Objective To study the specific findings of ganglioneuroma（GN） on plain CT and dynamic-enhanced CT images. Methods Ten patients with surgically and pathologically proved GN underwent plain CT and dynamic-enhanced arterial phase,portal venous phase and delayed phase CT scans.The CT findings of GN in all the patients were analyzed retrospectively.Results Among 10 patients with GN,7 cases were found in mediastinum,2 cases in adrenal gland,and 1 case in retroperitoneum.CT scans showed 2 cases of oval tumors and 8 cases of irregular tumors with sharply defined margins,ranged in size from 3.0×2.2×2.2 cm to 7.5×6.5×6.5 cm.Four patients presented with embedded growth feature.On plain CT images,the tumoral density was less than that of muscle,the masses with homogeneous density and nonhomogeneous density were found in 9 and 1 case,respectively.Three patients associated with intratumoral granular or stripe calcification.On dynamic-enhanced CT images,the masses presented with different enhanced patterns,of them,non-enhanced mass was only found in one case,unobvious enhancement in the arterial phase but gradually slight enhancement in the portal venous and delayed phase were found in 7 cases,and slight enhancement in the arterial phase and gradually significant enhancement in the portal venous phase and delayed phase were found in 2 cases.Conclusion GN has certain specific CT findings and enhanced features. Dynamic -enhanced CT can clearly show the relationship between the masses and surrounding structures,which are helpful for the diagnosis,differential diagnosis and guiding the surgery.