罕见部位神经源性肿瘤的临床及影像学诊断(附8例报告)

目的 探讨罕见部位神经源性肿瘤的影像表现，并提高术前诊断准确性。方法 本组8例患者，CT检查4例，胃肠道造影检查3例，胸部X线、B超、MRI和DSA检查各1例。所有病例均经病理证实为神经源性肿瘤。结果 影像检查并经病理证实，8例患者中，左前上纵隔恶性神经鞘瘤1例，左肺下叶支气管壁神经鞘瘤1例，回盲部肠系膜巨大神经鞘瘤1例，胃部神经源性肿瘤3例(腔内2例，腔外1例)，十二指肠降部腔外神经纤维瘤1例，以及盆腔右侧骶骨恶性孤立性神经纤维瘤l例。结论罕见部位神经源性肿瘤缺乏影像学特征，术前影像学检查大多能够做出正确的定位诊断，但与其相应部位的其他恶性肿瘤不易鉴别，确诊有赖于病理组织学检验。

Clinical and imaging diagnosis of neurogenic tumors in rare locations:a report of 8 cases

Objective To investigate the imaging findings of neurogenic tumors in rare locations and to improve the diagnostic accuracy before the operation.Methods Among 8 patients with pathologically proved neurogenic tumors,4 underwent CT plain and enhanced scans,3 underwent gastrointestinal barium meal examinations,and 4 underwent respectively chest X-ray examination (1),ultrasonography(1),MRI (1) and DSA (1).Results Imaging and pathology demonstrated that among 8 patients with neurogenic tumors there were 1 case of neurolemmoma in left anterior superior mediastinum,1 neurolemmoma in bronchial wall of left inferior pulmonary lobe,1 giant neurolemmoma in mesentery of ileocecal part,3 neurogenic tumors in stomach part (2 intracavity,1 extracavity),1 neurofibroma in extracavity of duodenal descending part,and 1 solitary malignant neurofibroma in right sacrum pelvic cavity.Conclusion Neurogenic tumors in rare locations are absent from imaging feature.Preoperative imaging examinations can mostly perform the localized diagnosis but can not differentiate from other malignant tumors in these locations.The definite diagnosis depends on histopathology.