摘要
目的:探讨消化系统神经鞘瘤的影像学特征并与病理进行对照,提高对该病的诊断水平。方法:回顾性分析经病理证实的18例消化系统神经鞘瘤(肝脏2例,胰腺2例,胃12例和十二指肠2例)的病理学与影像学特征,包括肿瘤的发生部位、形状、大小以及在CT和MRI上的影像学表现。结果:18例肿瘤中,类圆形16例,分叶状2例。CT平扫均为低密度,在T1WI上为不均匀低信号,在T2WI上为不均匀高信号。增强早期,所有肿瘤均表现为不均匀轻度强化;增强晚期,肿瘤呈渐进性强化,表现为中度或明显强化。11例肿瘤内部可见到小结节状异常强化灶。14例胃肠道型神经鞘瘤均未出现明显囊变,仅1例出现点状钙化。4例非胃肠道神经鞘瘤中,3例发生囊变;3例发生钙化。18例肿瘤均未见明显出血。结论:消化系统神经鞘瘤具有一定的特征,胃肠道型和非胃肠道型神经鞘瘤具有不同的影像学和病理学表现,掌握其影像学征象可提高对该病的术前诊断水平。
Objective：To study the imaging characteristics of schwannma in digestive system and correlated with pathology,in order to improve the diagnostic accuracy.Methods：To retrospectively analyze the imaging features of 18 cases with pathology proven schwannoma,including hepatic schwannoma（n=2）,pancreatic schwannoma（n=2）,gastric schwannoma（n=12）,duodenal schwannoma（n=2）.The location,morphology,size and the CT/MRI features were studied.Results：Of the 18 lesions,there were oval（n=16）and lobulated（n=2）in shape.All tumors showed low density on non-enhanced CT.On non-enhanced MRI,heterogeneous hypointensity was shown on T1 WI and hyperintensity on T2 WI.In the early phase after administration of contrast medium,tumors showed unevenly slight enhancement,then,gradually became moderately/markedly enhanced in the late phase.In addition,small nodular enhancement was seen in 11 tumors.No cystic change was seen in the 14 cases with gastrointestinal schwannoma and calcium was seen in only one case.Of the 4 cases with non-gastrointestinal schwannoma,cystic change and calcium was revealed in 3 cases.No hemorrhage was seen in all of the 18 cases with digestive system schwannoma.Conclusion：Certain characteristics can be assessed in schwannoma of digestive system.Different imaging and pathology features could be found in gastrointestinal and non-gastrointestinal schwannoma.The accuracy of diagnosis could be improved by understanding these imaging features.
作者
殷兵
朱文杰
李震
商功群
YIN Bing;ZHU Wen-jie;LI Zhen(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Chin)
出处
《放射学实践》
北大核心
2018年第7期708-712,共5页
Radiologic Practice
关键词
消化系统肿瘤
神经鞘瘤
体层摄影术
X线计算机
磁共振成像
病理
Digestive system neoplasms
Schwannoma
Tomography
X-ray computed
Magnetic resonance imaging
Pathology
