摘要
目的 :观察恶性外周神经鞘膜瘤(Malignant peripheral nerve sheath tumor,MPNST)的MRI特殊征象和一般征象,提高本病的术前诊断准确率。方法:回顾性分析26例经病理证实的MPNST的MRI表现,其中20例行增强扫描。结果:(1)特殊征象:不典型"靶征"12例,9例位于四肢处,2例位于腰椎椎管内,1例位于髋关节周围软组织;"神经出入征"6例,均位于四肢坐骨神经走行区;"束征"6例,均位于四肢处。(2)动态强化方式及增强:动态强化呈Ⅱ型强化方式8例(40%),Ⅰ型强化方式10例(50%),对应表现为环形、片状、结节状不均匀强化;Ⅲ型强化方式2例(10%),对应表现为较均匀强化。(3)一般征象:12例形态不规则,边缘毛糙,14例形态较规则,边缘光滑;5例没有侵犯周围组织,21例侵犯周围组织;22例(84.6%)T_1WI表现为等或低信号,25例(96.2%)T_2WI主要表现为等或稍高或混杂高信号。结论 :MPNST的影像学表现具有一定的特征性,其中特殊征象不典型"靶征"、"神经出入征"、"束征"及Ⅰ、Ⅱ型动态强化方式对诊断有较大的帮助。
Objective: To explore the typical and common MRI features of malignant peripheral nerve sheath tumor(MPNST) in order to improve the preoperative diagnostic accuracy. Methods: A total of 26 patients MRI with MPNST confirmed by pathology were analyzed retrospectively(n=26, 20 patients underwent enhanced scan). Results: ①Typical features: atypical“target sign”(n=12), 9 cases in the limbs, 2 cases in lumbar spinal canal, 1 case in the soft tissues around the hip joint; “entering or exiting nerve sign”(n=6), all were located in the region of the sciatic nerve; “fascicular sign”(n=6), all were located in the limbs. ②Dynamic enhancement modes: 8 lesions(40%) showed type Ⅱ, 10 lesions(50%) showed type Ⅰ, the solid parts showed annular or patchy or nodular inhomogeneous enhancement; 2 lesions(10%) showed type Ⅲ enhancement, the solid parts showed homogeneous enhancement.③Common features: 2 cases showed irregular shape, rough edge, 14 cases showed regular shape, smooth edge; Five cases did not infiltrate to the soft tissue, 21 cases were infiltrative; Twenty-two cases(84.6%) T1WI showed equal or low signal, 25 cases(96.2%) T2WI showed equal ormixed high signal. Conclusion: There were typical MRI features in most of the MPNST, the special signs such as atypical “target sign”, “entering or exiting nerve sign”, “fascicular sign”, the type Ⅰ, type Ⅱ dynamic enhancemant modes have helpful to make the diagnosis.
出处
《中国临床医学影像杂志》
CAS
2018年第2期121-125,共5页
Journal of China Clinic Medical Imaging
关键词
神经髓鞘瘤
磁共振成像
Nerve sheath tumors
Magnetic resonance imaging