寰枢椎骨神经鞘瘤影像学分析

Imaging Analysis of Atlantoaxial Bone Schwannoma

目的探讨寰枢椎骨神经鞘瘤影像学特点,提高影像诊断能力。方法搜集11例经手术病理证实的寰枢椎骨神经鞘瘤患者的影像学资料,主要包括X线、CT和MRI,分析其临床及影像学特点。结果寰枢椎骨神经鞘瘤发病年龄多为50岁以上中老年人好发(63.6%),男性多于女性(2.7:1);临床表现因个体差异而有所不同,多表现为颈部疼痛、运动障碍,体外触及包块等症状;影像上表现为良性骨肿瘤征象:寰枢椎膨胀性(45.5%)、溶骨性骨破坏区(100%),边界清楚(90.9%),伴边缘硬化边或扇贝征(81.8%),伴不规则分叶状或椭圆形软组织肿块(63.6%),密度/信号不均匀,可见囊变区(72.7%);肿瘤增大可突破骨质向外生长,压迫邻近结构;增强扫描肿瘤多为不均匀轻度至明显强化(85.7%)。结论寰枢椎骨神经鞘瘤的影像学表现具有一定的特异性。

Objective To investigate the imaging features of atlantoaxial bone schwannoma and improve the ability of imaging diagnosis.Methods The imaging data of 11 patients with atlantoaxial bone schwannoma confirmed by surgery and pathology were collected,including X-ray,computed tomography(CT)and magnetic resonance imaging(MRI).The clinical and imaging features were analyzed.Results Most of the patients with atlantoaxial bone schwannoma were over 50 years old(63.6%),and there were more males than females(2.7:1).The clinical manifestations vary from individual to individual.Most of the clinical manifestations are neck pain,movement disorders,external palpation of the mass and other symptoms.The imaging findings were as following:atlantoaxial expansion(45.5%),osteolytic bone destruction(100%),clear boundary(90.9%),sclerotic edge or scallop sign(81.8%),irregular lobulated or oval soft tissue mass(63.6%),uneven density/signal intensity,cystic degeneration(72.7%).When the tumor enlarged,it could break through the bone and grow outward,compressing the adjacent structures.Most of the tumors showed uneven mild to obvious enhancement(85.7%).Conclusion The imaging manifestations of atlantoaxial bone schwannoma have certain specificity.