目的：分析纵隔神经源性肿瘤的MRI平扫信号特点及强化特征，以加强对该病的认识和诊断准确性。方法：经手术病理证实为纵隔神经源性肿瘤33例，分别行MRI自旋回波T1WI、快速自旋回波T2WI以及屏气扰相梯度回波T1WI动态增强扫描，回顾性分析MRI扫描结果。结果：33例纵隔神经源性肿瘤中，神经鞘瘤18例，神经节细胞瘤7例，神经纤维瘤5例，副神经节瘤3例。肿块边界清楚，多呈圆形或椭圆形，MRI扫描T1WI呈均匀低信号，神经纤维瘤T2WI呈稍高信号，其余神经源性肿瘤T2WI多呈不均匀高信号；动态增强扫描神经鞘瘤10例动脉期不均匀轻度强化，静脉期、延时期呈不均匀延时明显强化，3例动脉期不均匀明显强化，静脉期、延时期呈持续性明显强化。神经纤维瘤动脉期均匀轻度强化，静脉期、延时期呈均匀延时明显强化。神经节细胞瘤呈轻、中度延时均匀强化。副神经节瘤动脉期明显不均匀强化，静脉期、延时期呈低强化。结论：纵隔神经源性肿瘤的MRI征象具有一定特点，有助于大多数病例术前正确诊断。
Abstract
Objective: To analyze the characteristics of MRI scan signal for mediastinal neurogenic tumors in order to enhance the understanding and diagnostic accuracy of the disease. Methods: There were 33 cases which were pathologically identified as mediastinal neurogenic tumors. Spin echo T1WI, fast spin echo T2WI, breath spoiled gradient echo T1WI MRI were used and retrospectively analyzed. Results: Among the 33 cases of mediastinal neurogenic tumor, there were 18 cases of neurilemmoma, ganglioneuroma in 7 cases, neurofibroma in 5 cases and 3 cases of paraganglioma. The boundary of the tumors was clear, mostly were round or oval. Through MRI scan, T1WI showed homogeneously low signal; T2WI showed slightly higher signal; the rest of the neurogenic tumors showed inhomogeneously high signal. Through dynamic enhanced scan, 10 cases of neurilemmoma were inhomogeneous slight enhancement in arterial phase and showed inhomogeneous delayed enhancement obviously in venous phase. Three cases of neurilemmoma were inhomogeneous enhancement obviously in arterial phase and showed continuous enhancement obviously in venous phase. Neurofibroma was homogeneous slight enhancement in arterial phase and showed even delayed enhancement obviously in venous phase. Ganglioneuroma showed slight and moderate homogeneous delayed enhancement. Paraganglioma showed inhomogeneous enhancement obviously in arterial phase and low enhancement in venous phase. Conclusion: MRI symptoms of mediastinal neurogenic tumors have some specific characteristics, which could be helpful for the correct diagnosis before operation.
关键词
纵隔肿瘤 /
磁共振成像
Key words
Mediastinal neoplasms /
Magnetic resonance imaging
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]张志庸，周易东，崔玉尚，等. 纵隔神经源性肿瘤的诊断和治疗[J]. 中华外科杂志，2002，40（9）：676-678.
[2]金腾，吴刚，李小明，等. 外周神经源性肿瘤的MRI表现与鉴别诊断[J]. 放射学实践，2014，29（10）：1213-1216.
[3]吴小凯，王其军，张辉. 纵隔神经源性肿瘤多层螺旋CT表现与病理对照研究[J]. 实用医学影像杂志，2014，15（1）：27-29.
[4]梁辉清，曾庆思，唐堪华，等. 胸部神经节细胞瘤影像学表现与病理分析[J]. 中国医学影像技术，2013，29（8）：1288-1291.
[5]Ozawa Y, Kobayashi S, Hara M, et al. Morphological differences between schwannomas and ganglioneuromas in the mediastinum: utility of the craniocaudal length to major axis ratio[J]. Br J Radiol, 2014, 87(1036): 20130777.
[6]Duffy S, Jhaveri M, Scudierre J, et al. MR imaging of a posterior mediastinal ganglioneuroma: fat as a useful diagnostic sign[J]. Am J Neuroradiol, 2005, 26(10)： 2658-2662.
[7]Ko S, Keum D, Kang Y. Posterior mediastinal dumbbell ganglioneuroma with fatty replacement[J]. Br J Radiol, 2007, 80(958): e238-e240.
[8]Johnson GL, Hruban RH, Marshall FF, et al. Primary adrenal ganglioneuroma: CT findings in four patients.[J]. Am J Roentgenol, 1997, 169(1): 169-171.
[9]关玉宝，张卫东，何建行，等. 胸部节细胞神经瘤的CT和MRI表现[J]. 中华放射学杂志，2011，45（12）：1136-1138.
[10]Lee KY, Oh Y, Noh HJ, et al. Extraadrenal paragangliomas of the body: imaging features[J]. Am J Roentgenol, 2006, 187(2): 492-504.
[11]王关顺，刘云霞，廖承德，等. 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.
[12]Yuan Y, Shi H, Tao X. Head and neck paragangliomas: diffusion weighted and dynamic contrast enhanced magnetic resonance imaging characteristics[J]. BMC Med Imaging, 2016, 16(1): 1-6.
[13]刘红军，梁长虹，刘再毅，等. MRI诊断肾上腺外副神经节瘤[J]. 中国医学影像技术，2010，26（10）：1837-1839.
