胸部节细胞神经瘤的CT和MRI表现

CT and MRI manifestations of the intrathoracic ganglioneuroma

目的 探讨胸部节细胞神经瘤的CT及MRI表现,提高对该病的诊断和鉴别诊断能力.方法 回顾性分析20例经手术病理证实的胸部节细胞神经瘤的临床、CT（14例）、MR（6例）平扫和增强扫描及所有病理学资料.结果 20例胸部节细胞神经瘤中,发生于后纵隔17例、侧胸膜2例、右侧整个胸腔1例.14例肿瘤平扫CT值20～40 HU,平均30.5 HU,4例伴有小结节状钙化,1例伴有斑片状脂肪密度影；动脉期增强CT值0～12 HU,平均6.2 HU,延迟期增强10～20 HU,平均14.3 HU.MRI检查5例在T1 WI上为均匀低信号,1例在T1WI上低信号内夹杂斑片状高信号脂肪影；T2WI上6例为不均匀高信号,其中1例呈旋涡状征象；增强后动脉期呈轻度不均匀强化,延迟期逐渐进行性轻度强化.结论 增强后CT及MRI显示肿瘤在动脉期不强化或轻微强化、延迟后逐渐轻度强化是胸部节细胞神经瘤的特征性表现.

Objective To evaluate CT and MRI findings of the intrathoracic ganglioneuroma and to improve its diagnosis and differential diagnosis ability.Methods Clinical,CT（ n = 14）,MRI （n = 6） and pathology manifestations of 20 patients with the intrathoracic ganglioneuroma were retrospectively analyzed.All 20 cases had chest CT and MRI plain scanning and multiphase enhance scanning before operation.Results Seventeen of 20 lesions were located in posterior mediastinum,2 in pleura side and 1 in right thorax cavity.The CT value of the plain scans ranged from 20 to 40 HU （ mean 30.5 HU）,Tubercle calcification were detected in four masses,one case with fat density was showed on CT scanning.After injecting contrast media,CT value ranged from 0 to 12 HU （mean 6.2 HU） in artery phase,ranging from 10 to 20 HU （ mean 14.3 HU） in delay phase.Five of 6 cases of MRI signals were homogeneously low intensity on T1 WI,1 case with fat signal was imhomogeneously low intensity on T1WI.Six cases were imhomogeneously high intensity on T2WI.A whorled appearance was visualized in one tumor on T2WI.The post-contrast enhancement MR images was slight enhancement imhomogeneously in artery phase and gradual increasing enhancement in delay phase.Conclusion On CT and MR imaging,no enhancement or slight enhancement in artery phase and gradual increasing enhancement in delay phase are characteristic manifestations of ganglioneuroma in the thorax.