肾上腺神经鞘瘤的诊断及临床特点并文献复习(附8例报告)

Diagnosis and clinical characteristics of adrenal schwannoma: report of 8 cases and literature review

背景与目的:肾上腺神经鞘瘤非常少见,多为良性,缺乏特异性的临床及影像学表现。该研究通过对肾上腺神经鞘瘤的CT和MRI表现与病理对照分析,提高对肾上腺神经鞘瘤的诊断水平。方法:回顾性分析经病理证实的8例肾上腺神经鞘瘤患者的CT和MRI影像特征,其中4例患者仅行CT扫描,3例患者仅行MR扫描,1例患者行CT和MR扫描。并将影像学诊断结果与病理诊断结果进行对比分析。结果:5例肿瘤位于左侧肾上腺,3例位于右侧肾上腺;所有患者均未出现内分泌症状。所有8例肿瘤表现为边界清楚的类圆形、分叶状肿块,2例肿瘤见钙化,5例肿瘤伴囊变,2例肿瘤伴出血;7例肿瘤CT或MRI的强化表现为中度不均匀、延迟强化,并可见强化的包膜,4例肿瘤增强可见兔尾征。结论:肾上腺神经鞘瘤的影像及病理有一定的特征性,完整包膜、囊变、兔尾征、钙化及渐进强化等影像征象有助于提高肾上腺神经鞘瘤的诊断准确率。

Background and purpose： Adrenal sehwannoma is extremely rare, mostly benign, lack of special characteristics in clinical and imaging presentation. The aim of this study was to analyze the computed tomography （CT） and magnetic resonance imaging （MRI） findings of adrenal schwannoma, in order to improve the accuracy of diagnosis. Methods： The CT and MRI features of 8 patients with pathology-proven adrenal sehwannoma were reviewed. Among the 8 patients, 4 patients underwent CT scanning, 3 patients underwent MR scanning, 1 patient underwent both CT and MR scanning. Results： The tumors were located at the left adrenal in 5 cases and at the right in 3 cases. Tumors showed no signs of endocrine activity in all cases. All tumors were well-circumscribed, oval or lobulated masses, 2 cases with calcification, 5 cases with cystic change, 2 cases with intratumoral hemorrhage. CT or MR enhancement showed moderate, heterogeneously delayed enhancement in 7 cases with enhanced capsule. Four cases showed rabbit tail sign. Conclusion： The imaging and pathological features of adrenal sehwannoma have certain characteristics. The CT and MRI features, such as intact capsule, cystic degeneration, rabbit tail sign, calcification and progressive enhancement, are helpful to improve the accuracy of diagnosis of adrenal sehwannoma.