腹膜后神经源性肿瘤多模态影像表现与病理对照

Multi-modal imaging findings of retroperitoneal neurogenic tumors and pathologic correlation

目的探讨腹膜后神经源性肿瘤的影像学表现及病理特征,提高本病诊断准确性。方法回顾性分析30例经病理证实的腹膜后神经源肿瘤的影像表现及临床资料,并与病理进行对照分析。结果 30例均位于脊柱旁或骶前区,27例良性,边界尚清,呈类圆形多见。神经鞘瘤12例,易囊变、钙化,增强呈渐进性强化,其中2例完全囊变呈厚壁假囊肿,1例为富于细胞性;神经纤维瘤1例呈丛状生长,与周围肌肉关系密切;节细胞神经瘤11例,好发于肾上腺区,少有囊变,增强呈渐进性强化或分隔样、斑驳样强化;副神经节瘤3例呈富血供,动脉期可见粗大血管影、T2WI呈现"椒盐征"。恶性3例即神经母细胞瘤,形态不规则,见粗大、不定形钙化,结合PET、CT、MR多模态检查凸显转移灶及确定肿瘤分期。结论腹膜后不同神经源性肿瘤的影像学表现具有一定特异性并能反映其病理变化,可提供更可靠的诊断价值,有助于提高诊断的准确性。

Objective To explore the imaging manifestations and pathological characteristics of retroperitoneal neurogen- ic tumors so as to improve the diagnostic accuracy of the disease. Methods The imaging findings and clinical data of 30 patients with retroperitoneal neurogenic tumors confirmed by pathology were analyzed retrospectively and compared with pathology features. Results All 30 tumors located in the paraspinal and sacral areas, 27 benign cases had well-defined boundary and appeared roundish. In 12 neurinoma, most often occured cystic formation and calcification, enhanced scan rendered gradual enhancement, 2 cases of complete capsule be came a thick wall pseudocyst, 1 case was cellular schwanno- ma. 1 Neurofibroma presented plexiform and had close relation with the adjacent muscle. 11 ganglioneuroma were used to appear Adrenal area, rarely cystoid variation, gradual Strengthenment or Separated sample mottled appearance enhance- ment on enchanment scan. 3 paraganglioma appeared rich blood supply and visible to strengthen coarse vessels in arterial phase, like ＂salt and pepper＂ in TzWI. 3 cases of neuroblastoma had irregular Shape and coarse amorphous calcification. Metastases and the definite installmen were highlighted by multimodal way include PET, CT and MRI. Conclusion Ima- ging manifestations not only has specificity for the diagnosis the different types of retroperitoneal neurogenic tumors but al- so can reflect relevant pathological changes , thus provided reliable value in the diagnosis and be helpful for improve the ac- curacy of diagnosis.