MSCT增强扫描对颈部神经鞘瘤的诊断价值

Evaluation of Contrast-enhanced MSCT in the Diagnosis of Cervical Neurilemmoma

目的:探讨多层螺旋CT(MSCT)增强扫描对颈部神经鞘瘤的诊断价值。方法:对经手术病理证实的20例颈部神经鞘瘤患者的CT图片进行回顾性分析,分别在轴位、二维图像上观察神经鞘瘤肿块的CT表现。结果:18例肿块位于颈动脉间隙内,1例位于颈后区,1例位于腮腺区。CT平扫表现为不均匀等低密度肿块18例,均匀等密度肿块2例;增强后18例早期不均匀强化、延迟扫描呈渐进性强化,2例强化均匀;18例有不同程度的血管推移征。结论:MSCT增强扫描对颈部神经鞘瘤能准确定位,清晰显示肿块与邻近血管等重要结构的解剖关系,延迟后渐进性强化及颈动脉间隙血管移位征象有很高的定性诊断价值,对临床诊断和手术治疗具有重要的指导意义。

Objective： To investigate the value of contrast-enhanced scanning of multi-slice CT in the diagnosis of cervical neurilemmoma. Methods： Imaging data of 20 cases, who were suffered from cervical neurilemmoma confirmed by surgery and pathology, were analyzed retrospectively. Cervical neurilemmoma masses were observed with CT axial and dimension images. Results： 18 cases located at carotid space, 1 case located at posterior cervical triangle, 1 case located at parotid region. 18 cases appeared as inhomogeneous isopycnic and low-density masses, 2 cases appeared as homogeneous isopycnic masses with CT plain scan, after enhancement scanning, 18 cases appeared as inhomogeneous enhancement in artery phase and progressive enhancement with delayed scanning, 2 cases appeared as homogeneous enhancement. 18 cases all appeared as vascular displacement in carotid space. Conclusion： Enhancement scanning of multi-slice CT can precisely localize the cervical neurilemmoma and reveal the anatomic relationships between the mass and adjacent blood vessels and other important structures. Delayed progressive enhancement and vascular displacement in carotid space have great determined diagnostic value, which will provide important guiding value for clinical diagnosis and operation treatment.