胸壁肋间神经鞘瘤的CT表现特征

The Feature of CT Diagnosis of the Chest Wall Intercostal Neurinoma

目的探讨胸壁肋间神经鞘瘤的CT表现特点,评价其对本病的诊断价值。方法回顾性分析经手术及病理证实的10例肋间神经鞘瘤的CT表现,全部行螺旋CT平扫及增强三期扫描。结果 10例神经鞘瘤,男6例,女4例,3例位于左前胸壁,2例位于右前胸壁,4例位于左腋中线胸壁,1例位于右腋中线胸壁,其中有2例凸向肺内,最大层面位于肺内,与相应胸壁交角成钝角。相应胸膜增厚3例。邻近肋骨压迫性骨质吸收3例,骨质硬化2例。其中2例相应肋间隙增宽。CT平扫密度呈均匀实质性肿块2例,呈密度不均匀囊实肿块5例,密度不均匀以囊性为主肿块3例。增强后明显强化6例,轻～中度不均匀强化4例。平扫及增强8例病灶内见低密度囊变区。10例病灶均有延迟强化表现及趋势。结论 CT检查对胸壁肋间神经鞘瘤的定位、定性诊断具有较高的价值,一般根据CT表现特征,结合临床术前诊断不难。

Objective To probe the feature of CT appearance of the chest wall intercostal Neurinoma,to elevate the CT diagnostic value for primary disease. Methods The CT findings of 10 cases of analyzed the feature of CT appearance of 10 cases of chest wall intereostals schwannoma. By operation and pathology were analyzed retrospectively. All cases were performed by CT plain and enhanced three stages scanning. Results 10 cases neurinoma, male 6 examples, female 4 examples, three cases located left anterior chest wall, two cases located right anterior chest wall, four cases located left midaxillary line chest wall, one case located right midaxillary line chest wall, among two cases protruding toward intralung, largest deck located intra-lung, together to corresponding chest wall to meet angle to become obtuse angle, thickened pleura of three cases. Vicinity ribs to oppress bone absorp- tion of three cases, osteoselerosis of two cases. Among corresponding intercostal space widen of two cases. CT plain to submit uniformity solid tumor mass of two cases, to submit uneven sack sthenia edema tumor of five cases, density uneven by mean of spina bifida cystica for host tumor of three cases. After CT enhance obviously to strengthen 6 cases, lightly or midrange uneven to strengthen 4 cases. Inside focus to see low density area to plain scan and strengthen 8 cases. Delayed reinforcement and teudency of 10 cases. Conclusion CT plain and enhanced three stages scanning to show is higher value in localizable and qualitative diagnosis for the chest wall intercostal neurinoma.preoperative diagnosis not difficult to foundation to show characteristic and combine clinical.