外周神经纤维瘤的超声诊断

Sonographic features of peripheral diffuse neurofibroma

目的探讨外周神经纤维瘤弥漫型的声像图特征。方法回顾性分析经病理证实的外周神经纤维瘤弥漫型患者10例,观察病变的位置、大小、形态、边界、回声特点、血流分布等。结果所有患者均表现为边界不清的皮下软组织增厚(10/10),多数病变区呈弥漫型回声增强伴多发条带状或结节状低回声(7/10),多数病变区内见大量血流信号(8/10)。有以下3种类型:(1)结节型多数为卵圆形、低回声、边界清晰、后方回声增强内部血供较丰富,4例生长在较大神经干的肿瘤可见瘤体与神经干相连;(2)蔓丛型表现为单发或多发低回声结节伴周围条带状低回声与之相连,结节内血供较丰富;(3)弥漫型均表现为皮下脂肪层增厚伴边界不清。结论蔓丛型及弥漫型神经纤维瘤的声像图表现具有一定特征性,结合临床表现超声容易作出正确诊断。

Objective To investigate high-resolution sonographic appearances of peripheral diffuse neurofibroma. Methods Seven patients were detected with high-resolution sonography retrospectively and their histopathologic results were proved by surgery. The tumor position, size, growth pattern, echo pattern, and vessels were included in the observation. Results All diffuse neurofibromas were ill-defined and irregular marginated （10/10）, and the echogenicities were mostly found as multiple strip-like or nodular hypoechoic areas in a hyperechoic background with plenty of vessels （8/10） . （1） Most of the lesions were oval,well defined, hypoechoic masses with posterior acoustic enhancement and inner increased vascularity,Four lesions arose from and connected with the large nerve trunks were visualized. （2） All lesions had a single or multiple hypoechoic nodules and connected with multiple peripheral strip like hypoechoic lines. The vascularity was extensive in all lesions. （3） AII lesions located in the subcutaneous fat layer with ill defined margins. Conclusion Plexiform neurofibromas and diffuse neurofibromas have characteristic sonographic appearances, therefore,sonography is of great value in the diagnosis of these diseases.