四肢软组织良性神经鞘瘤的MRI表现

MRI Imaging of Benign Peripheral Neurilemmoma of the Extremities

目的分析四肢软组织良性神经鞘瘤的MRI表现。方法回顾性分析16例经病理证实的四肢良性神经鞘瘤的MR影像资料。全部病例均行常规MR平扫扫描,应用T1WI、T2WI、脂肪抑制T2WI和脂肪抑制PDWI加权序列作轴位、冠状位和矢状位扫描。结果 16例均表现为边界清楚的梭形或类圆形肿块,沿神经走行方向生长,均为单发。在T1WI上10例呈均质稍低信号,6例为不均质低-中等信号强度。在T2WI及PDWI像上16例均呈不均质高信号。8例可见束状征,7例可见靶征,8例可见神经出入征,10例可见脂肪分离征,4例同时出现以上4种征象。结论 MR有利于明确肿瘤的位置和范围。靶征、神经出入征、脂肪分离征的存在有助于四肢良性神经鞘瘤的诊断。

Objective To evaluate MR imaging of benign peripheral neurilemmoma in soft tissue of the extremities. Methods MR imaging of benign peripheral neurilemmoma of the extiemities in 16 cases proved by surgery and pathology were retrospectively reviewed. MR routine scanning was performed in axial, coronal, and sagittal planes, including turbo spin-echo T1-weighted, turbo spin-echo T2-weighted, turbo spin-echo T2-weighted fat-saturated images and proton density-weighted fat-saturated images（PDWI） in all cases. Results The tumors in all of the 16 cases were fusiform or round masses, well-defined and with the extent along the nerve disturbution. All 16 cases were single. 10 masses showed low signal intenstity on T1WI and 6 cases were low-medium signal intensity. All showed heterogeneous high signal intensity on T2WI and PDWI. The lesions with“fascicular”sign in 8 cases,“target”sign in 7 cases, nerve entering and exiting the tumor in 8 cases,“spilt-fat”sign in 10 cases were detected, and 4 cases appeared the four signs above simultaneously. Conclusion MRI is useful in defining the location and extent of a lesion. The typical MRI appears to be a useful sign in the diagnosis of the benign peripheral neurilemmoma in the extremities.