神经鞘瘤影像表现与术前误诊分析
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山东第一医科大学第二附属医院

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Imaging findings and preoperative misdiagnosis of schwannoma
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The Second Affiliated Hospital of Shandong First Medical University

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    摘要:

    中文摘要:目的:回顾性分析多部位神经鞘瘤的CT、MRI表现,以降低本病术前误诊率。方法:收集本院31例经手术病理证实的神经鞘瘤临床表现及影像学资料,结合病理,分析总结病灶的影像学特征。结果: 31例不同部位神经鞘瘤均为单发病灶,椭圆形及类圆形占87.10%(27/31),哑铃型占9.68%(3/31),分叶状占3.23%(1/31)。病灶以实性为主(17/31)最多,囊实性(10/31)其次,囊性为主(4/31)最少。CT平扫呈稍低或低密度,MRI信号不均匀,增强扫描呈延迟或持续强化。83.87%(26/31)病灶沿神经方向走行。四肢病灶MRI多表现为囊实性、靶征、神经出入和脂肪分离征。椎管病灶(11/12)可见“脑脊液尾征”。腮腺内、胸腔壁及胃壁病灶未见神经鞘瘤典型征象,术前误诊。结论:常见部位神经鞘瘤具有典型影像表现,易于诊断。少见部位神经鞘瘤易误诊。

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    Abstract:[Objective] To retrospectively analyze the CT and MRI findings of schwannoma in multiple sites, so as to reduce the misdiagnosis rate of the disease before operation. [Methods] The clinical manifestations and imaging data of 31 cases of schwannoma were collected. Combined with the pathological results, the imaging features of the lesions were analyzed and summarized. [Results]31 cases of schwannomas at different sites were single lesions. The lesions were mainly oval and round(87.10%, 27/31), and a few were dumbbell(9.68%, 3/31) or lobulated (3.23%, 1/31)). Most of the lesions were solid(17/31), followed by cystic with solid(10/31) and cystic(4/31). CT showed slightly low or low density, while MRI showed heterogeneous signal. Enhanced scan showed delayed or continuously enhancement. Most of the lesions(83.87%, 26/31) were along the nerve. Most of the lesions in extremities were cystic with solid, target sign, nerve access and typical fat separation. Cerebrospinal fluid tail sign was found in 11 lesions of the spinal canal(11/12). No typical signs of schwannoma were found in the lesions of the parotid gland, chest wall and gastric wall, which were misdiagnosed before operation. [Conclusion]Schwannoma in common sites have typical imaging features and are easy to diagnose..Schwannoma in rare sites is prone to be misdiagnosed.

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  • 收稿日期:2021-01-06
  • 最后修改日期:2021-05-14
  • 录用日期:2021-06-04
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