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目的分析腹膜后间隙神经鞘瘤的320排CT表现及与病理的关系,探讨320排CT对其诊断和鉴别诊断价值。方法回顾性分析22例经手术病理证实的腹膜后间隙神经鞘瘤的320排CT表现及病理结果。术前均行320排CT平扫与三期增强检查。结果 (1)22例中,良性神经鞘瘤19例,恶性神经鞘瘤3例,盆部腹膜外间隙3例,腹腔腹膜后间隙19例。(2)CT表现,完全囊变型7例,囊实性型12例,完全实性型3例;良性肿块边缘光整,境界清楚,恶性肿块局部边界模糊;所有肿块实性部分呈渐进性延迟轻中度强化,平扫、增强动脉期、门静脉期、延迟期CT值分别(35.40±7.70)HU、(45.09±8.71)HU、(56.27±10.33)HU、(68.64±12.68)HU;术前定位准确度100%,定性准确度90.90%(20/22)。(3)病理表现,镜下,肿瘤内可见Antoni A区和Antoni B区两种组织类型,Antoni A区细胞密集排列,Antoni B区细胞稀少,细胞间有较多液体存在,常伴各种退行性变。结论腹膜后间隙神经鞘瘤的320排CT表现有特征性,CT表现取决于细胞稀疏区与密集区的比例和排列方式,囊实性多见,呈渐进性延迟轻中度强化,边界清楚,CT对腹膜后神经鞘瘤的定位定性诊断具有重要价值。
OBJECTIVE: To analyze the relationship between 320-slice CT findings and pathology in retroperitoneal space schwannomas and to evaluate the diagnostic and differential diagnosis of 320-slice CT. Methods A retrospective analysis of 22 cases of retroperitoneal space schwannomas confirmed by surgery and pathology showed 320-slice CT findings and pathological findings. Preoperative 320 row CT scan and three enhanced examination. Results (1) In 22 cases, 19 cases of benign schwannoma, 3 cases of malignant schwannoma, 3 cases of extraperitoneal tuberculosis and 19 cases of peritoneal retroperitoneal space. (2) CT manifestations: 7 cases of complete cystic deformity, 12 cases of cystic solid type and 3 cases of complete solid type. The margin of benign mass was clear and the state was clear. The boundary of malignant mass was blurred. The solid part of all masses showed progressive retardation The CT value of the arterial phase, portal vein phase and delayed phase were (35.40 ± 7.70) HU, (45.09 ± 8.71) HU, (56.27 ± 10.33) HU and (68.64 ± 12.68) HU respectively in mild to moderate enhancement, Positioning accuracy of 100%, the qualitative accuracy of 90.90% (20/22). (3) The pathological findings showed that in the tumor, there were two types of tissue in Antoni A area and Antoni B area. The cells in Antoni A area were densely arranged, and the cells in Antoni B area were scarce with more liquid in the cells. Sexual change. Conclusion 320-row CT manifestations of retroperitoneal space schwannoma are characteristic. CT appearance depends on the proportion and arrangement of sparse cells and dense areas, cystic solidity is more common, progressive delay mild to moderate enhancement, clear boundary, CT of retroperitoneal schwannoma localization of qualitative diagnosis of great value.