浅表神经鞘瘤的声像图特点及常见误诊原因分析

The ultrasonographic characteristics and common misdiagnosis reason of superficial neurilemmoma

目的探讨浅表神经鞘瘤的超声表现及鉴别诊断,提高超声对浅表神经鞘瘤的诊断准确率。方法回顾性分析51例经病理检查确诊的浅表神经鞘瘤的患者的超声表现,并从大小、形态、包膜、内部回声、血流信号及周围神经关系等方面对误诊原因进行分析。结果浅表神经鞘瘤在形态、包膜、内部回声、血流信号等方面具有一定的特点,但辨别其与周围神经关系是鉴别其他病变的关键。本组病例中,超声对神经鞘瘤的诊断符合率78.4%。结论浅表神经鞘瘤与神经纤维瘤、皮脂腺囊肿等在形态、包膜、内部回声、血流信号等声像图上具有一定相似性,在诊断时需要加以鉴别,尤其重视神经鞘瘤与周围神经关系。

Objective To investigate the ultrasonic features and differential diagnosis of superficial neurilemmoma ,and improve diagnostic accuracy of superficial neurilemmoma by ultrasound .Methods Retrospectively analyse the ultrasonic findings of 51 ca-ses ,which confirmed for superficial neurilemmoma by pathology ,and analyse the misdiagnosis reason from the aspects of size , shape ,boundary ,internal echo ,blood flow signals .Results Superficial neurilemmoma had some characteristics in the shape ,bound-ary ,internal echo ,blood flow signals and so on .However ,the key point to differentiate it from other diseases was to identify the re-lationship with peripheral nerve .In this study ,the coincidence rate of ultrasonoic diagnosis with pathologic diagnosis was 78 .4% . Conclusion Superficial neurilemmoma have some similarity with neurofibroma or sebaceous cyst on ultrasonographic images .When making diagnosis ,especial attention should be paid to identify the relationship of neurilemmoma with peripheral nerve .