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目的 提高胸部神经源性肿瘤CT诊断水平。材料和方法 回顾性分析23例经手术及病理证实的胸部神经源性肿瘤的CT表现。结果 (1)纵隔内18例,胸壁5例,其中神经纤维瘤9例,神经鞘瘤7例(恶性1例),神经节细胞瘤4例,神经母细胞瘤3例。(2)良性肿瘤边界清晰、锐利,神经纤维瘤多中等大小,圆形多见、易囊变,可有钙化,可发生于胸壁皮下组织或前纵隔。神经鞘瘤体积多偏小,多见椭圆形,易引起椎间孔受压扩大,可发生于胸壁肋间神经 神经节细胞瘤体积多偏大,呈长条形,宽基底与脊柱相贴,钙化多见,一般不引起椎间孔受压扩大。(3)恶性神经源性肿瘤边界多欠清,可见坏死区及侵犯邻近胸膜等结构,神经母细胞瘤钙化多见。结论 CT是诊断胸部神经源性肿瘤有效方法,结合患者年龄及CT特点,在一定程度上可推测其病理类型。
Objective To improve the CT diagnosis of thoracic neurogenic tumors. Materials and Methods CT findings of 23 cases of thoracic neurogenic tumors confirmed by surgery and pathology were retrospectively analyzed. Results (1) There were 18 cases in the mediastinum and 5 cases in the chest wall, including 9 cases of neurofibromatosis, 7 cases of schwannomas (1 case of malignant), 4 cases of ganglioneuroma, and 3 cases of neuroblastoma. (2) Benign tumors have clear and sharp borders. Neurofibromas are medium and large in size. They are more common in circles and easy to change into cysts. They may have calcification and may occur in the subcutaneous tissue or anterior mediastinum of the chest wall. The size of schwannoma is too small, oval shape is more common, and the intervertebral foramen is easily compressed. It can occur in the intercostal nerve ganglionous cell tumor of the chest wall. The volume of the nerve ganglionoid tumor is large and large, showing a long strip, with a wide base and the spine. Calcification is more common, generally does not cause the expansion of intervertebral foramen compression. (3) The borders of malignant neurogenic tumors are mostly clear, the necrotic areas are visible, and the adjacent pleura is invaded. The calcification of neuroblastomas is more common. Conclusion CT is an effective method for the diagnosis of thoracic neurogenic tumors. Combined with the age and CT features of the patients, it can be inferred to a certain extent.