胸部神经鞘瘤符合线路SPECT显像的影像学特征

Image characteristics of chest schwannoma in coincidence ^18F-FDG SPECT studies

目的 总结气管内和纵隔神经鞘瘤的^18F-FDG符合线路SPECT显像的影像学特点及其对神经鞘瘤的术前评估作用.方法 回顾性分析经手术、病理证实的4例神经鞘瘤患者CT和符合线路SPECT影像学表现,结合文献提出对诊断周围性神经鞘瘤有价值的影像学特点.结果 4例均经过手术全切除后病理、HE和免疫组织化学染色病理证实,1例为恶性,3例为良性.良性神经鞘瘤为明显分叶,边界清楚,呈非侵袭性生长,主要表现压迫症状,18 F-FDG摄取均不同程度升高,不具备特异性;恶性神经鞘瘤表现为侵袭性生长,18 F-FDG摄取较良性明显增高.结论 ^18F-FDG符合线路SPECT对周围神经鞘瘤的良恶性鉴别诊断价值有限,但对神经鞘瘤的术前评估、分期起着重要作用.

Objective To analyze the image characteristics of chest schwannoma in coincidence ^18FFDG SPECT studies,and to evaluate its prospective diagnostic function on chest schwannoma.Methods Four cases confirmed as schwannoma by surgery and pathology were enrolled in this retrospective study.Enhanced CT and coincidence ^18F-FDG SPECT studies were performed before surgery.Imaging characteristics for the diagnosis of chest schwannoma were summarized.Results Tumors were totally removed by surgery.The histological diagnosis of schwannoma was confirmed by pathological,HE and immunohistological staining examination （positivity for the S-100 protein and vimentin）,including 1 case of malignant schwannoma and 3 cases of benign.Four cases all showed high uptake of ^18F-FDG.The uptake in malignant schwannoma was much higher than that in benign schwannoma.Benign schwannomas were noninvasive masses and mainly showed compression symptoms,with obvious lobulation and distinct borders.Malignant schwannoma was invasive masses.Conclusions 18 F-FDG coincidence SPECT is of limited value as a prospective diagnostic imaging technique for the identification of benign schwannoma from malignant schwannoma.But it could play an important role in the staging,restaging,and post-therapy follow-up of schwannoma.