摘要
目的探讨肾上腺外神经节细胞瘤(GN)的CT特征,以提高对该病的认识和诊断水平。资料与方法回顾性分析13例经手术、病理证实的肾上腺外GN的CT表现,并与病理结果进行对照。结果 13例肾上腺外GN患者中2例位于颈部,4例位于后纵隔,4例位于腹膜后,2例位于骶前,1例位于肾门区。肿块边界清晰,2例病灶呈圆形,3例呈类圆形,8例呈不规则形。不规则形中,6例呈塑形生长,包绕或推移周围血管,但血管形态正常,无侵犯征象;2例侵及椎间孔。CT平扫肿块密度低于肌肉,密度均匀4例,不均匀9例,其中2例病灶内见点状钙化。增强扫描5例病灶无强化,8例病灶动脉期轻度强化,静脉期及延迟期轻至中度持续强化。镜下示肿瘤含大量黏液基质,其间散在神经纤维细胞、胞质丰富的节细胞和毛细血管。结论肾上腺外GN的CT表现具有一定的特征性,与病理特点有较好的相关性,有助于诊断和鉴别诊断。
Purpose To explore the CT features of extra-adrenal ganglioneuroma （GN）, and to improve the diagnostic accuracy of the disease. Materials and Methods CT features of 13 patients with extra-adrenal GN confirmed by surgical pathology were retrospectively analyzed, and compared with pathological findings. Results Two of 13 lesions were located in neck, four in posterior mediastinum, four in retroperitoneal space, two in front of sacrum, one in the region of renal hifus. All these masses were well defined, two appeared as round, three as oval, 8 as irregular shape. Of eight cases with irregular shape, six lesions presented a tendency of wedging into the space encasing and lapsing the vessel, with no evidence of invasion of the surrounding organs or vessels. Two tumors grew along the vertebrae and invaded intervertebral foramen. On plain CT imagings, the attenuations of the tumors were less than that of muscle, the masses with homogeneous and nonhomogeneous density were found in four and nine cases, respectively. Two patients associated with scattered and patchy cafilication. After contrast administration, eight lesions showed inhomogeneous enhancement： slight enhancement were seen in the arterial phase and gradually more strong enhancement during the portal venous and delayed phase. Enhancing lines or patchy were observed inside these tumors. Pathologically, the tumors appeared on a large amount mucus background, a few of scattering or nesting ganglion cells were distributed in many mature spindle cells, which lined in weave or fasciculation. Conclusion CT manifestations of extra-adrenal GN have certain characteristics, which are correlated closely with pathological features, therefore is helpful for the diagnosis and differential diagnosis.
出处
《中国医学影像学杂志》
CSCD
北大核心
2013年第12期928-931,共4页
Chinese Journal of Medical Imaging
