副神经节瘤的CT和MRI表现

王关顺; 刘云霞; 廖承德; 张大福

中国临床医学影像杂志 ›› 2014, Vol. 25 ›› Issue (8) : 542-546.

论著

副神经节瘤的CT和MRI表现

王关顺1，刘云霞2，廖承德1，张大福1

作者信息 +

CT and MRI manifestations of paraganglioma

WANG Guan-shun1, LIU Yun-xia2, LIAO Cheng-de1, ZHANG Da-fu1

Author information +

文章历史 +

摘要

目的：探讨CT和MRI在副神经节瘤中的诊断价值。方法：回顾性分析26例经手术或病理证实的副神经节瘤的CT和MRI表现，所有26例均行CT扫描，16例行MRI检查。分析肿瘤的位置、大小、形态、密度、信号特点及强化方式。结果：CT表现为边界清楚或不清楚的软组织肿块，肿块呈圆形或类圆形和不规则形。平扫呈等低密度者23例，高密度者3例，增强多为持续性强化，动脉期中度-明显强化，实质期明显强化，延迟期强化程度轻度减低，24例增强后强化不均，病灶内见斑片状出血坏死区，2例强化均匀，1例病灶内有钙化，2例可见病灶周围水肿表现，1例侵犯邻近骨质。6例恶性者肿块向周围结构侵犯，伴有肝脏、双肺或淋巴结转移。肿瘤最大径线为2.5～13.5 cm（平均6.38 cm）。MRI上副神经节瘤多表现为较大软组织肿块，T1WI呈等低信号，T2WI为中等或高信号或不均匀混杂信号，DWI呈高信号，增强扫描肿瘤实质部分明显强化。结论：CT和MRI是副神经节瘤定位、定性诊断的重要影像学检查方法，CT能够很好地显示肿瘤本身及其与周围结构的关系，MRI的信号变化能够反映肿瘤组织学成分的不同，CT和MRI在早期发现病灶、副神经节瘤的诊断与鉴别、判断病灶与周围组织结构的关系方面具有重要意义。

Abstract

Objective: To investigate CT and MRI features of paraganglioma. Methods: Imaging features in 26 cases of paraganglioma confirmed by surgery and pathology were analyzed retrospectively. Among them, all of the 26 patients underwent CT scan, and 16 patients underwent MRI scan. Tumor location, size, shape, density, signal intensity and enhancement pattern were studied on CT and MRI. Results: Paraganglioma showed oval or round, irregular masses with ill- or well-defined margins. The tumors showed hypo- or iso-density in 23 cases and hyper-density in 3 cases on unenhanced CT images. Contrast-enhanced CT images demonstrated medium-intense enhancement in the arterial phase, marked enhancement in the parenchymal phase and mild decrease of enhancement in the delayed phase. The tumors revealed a continued heterogeneous or homogeneous enhancement mass with patchy bleeding and necrotic foci in 24 cases, calcification in 1 case, perilesional edema in 2 cases and bony destruction in 1 case. All 6 malignant cases showed a large mass and extensively spread to the adjacent tissues and liver with pulmonary or lymph nodes metastasis. Tumor size ranged from 2.5 to 13.5 cm(mean=6.38 cm). Paraganglioma manifested as a large mass of hypo- or iso-intensity on T1-weighted image and intermediate to high signal intensity or heterogeneous mixed intensity on T2-weighted images. The tumors showed higher intensity on DWI and marked enhancement of solid components on contrast-enhanced T1-weighted images. Conclusion: CT and MRI are an effective method of imaging examination for the quantitative and qualitative diagnosis of paraganglioma. CT can display features of the paraganglioma and correlation with surrounding tissues. The signal alteration of MRI can reflect different histological components of the tumors. CT and MRI are valuable in early discovery of lesions, detecting and differentiating paraganglioma, estimating the relation between lesion and adjacent tissues.

导出引用

王关顺;刘云霞;廖承德;张大福. 副神经节瘤的CT和MRI表现[J]. 中国临床医学影像杂志. 2014, 25(8): 542-546

WANG Guan-shun;LIU Yun-xia;LIAO Cheng-de;ZHANG Da-fu. CT and MRI manifestations of paraganglioma[J]. Journal of China Clinic Medical Imaging. 2014, 25(8): 542-546

中图分类号： Ｒ739.43 Ｒ814.42 Ｒ445.2