目的:分析胸壁神经鞘瘤的CT表现,以提高该病的诊断准确性.方法:回顾性分析经病理证实的8例胸壁神经鞘瘤的CT表现及相关临床资料.结果:8例发病部位均在右侧胸壁,呈孤立型肿块7例,弥漫型肿块1例.1例位于脊柱旁;7例位于肋缘或肋间,其中2例位于胸壁皮下软组织内,查体胸壁上可触及明显肿物,5例位于肋内侧缘,均对肺组织造成不同程度压迫.CT均表现为不同程度低密度影,密度低于邻近肌肉组织,边缘清晰,平均大小4.3cm×3.9cm,平均CT值14HU,增强扫描无强化或不均匀强化,平均动脉期、静脉期CT值分别为18、27HU.3例伴囊性变,1例病灶内出现点状钙化,2例伴胸水.肿块直径>5cm3例,邻近肋骨均受压变扁,其中1例呈弥漫型分布者邻近肋骨有骨质破坏,提示恶变.结论:胸壁神经鞘瘤发病率低,其CT表现具有一定的特异性,但确诊还需依赖病理检查.%Objective:To analyze CT features of chest wall schwannoma to improve its diagnostic accuracy. Methods:CT and clinical data of 8 cases confirmed as chest wall schwannoma were retrospectively analyzed. Results:All lesions were located in the right chest wall,7 cases had solitary mass and 1 had disseminated lesion. One tumor was located near the spinal column. 7 cases located in costal margin or intercostal,of them,2 presented with palpable masses on the right chest wall and 5 located in the inside edge of ribs which compressed adjacent pulmonary tissues. CT imaging showed soft tissue masses with an average size of 4.3 cm×3.9 cm,the average CT value was 14 HU,lower than the adjacent muscular tissue. No enhancement or heteroge-neous enhancement was found,the average double phase CT values were 18 and 27 HU,respectively. 3 cases had cystic degen-eration,1 had punctate calcification,2 had pleural effusion. 3 large masses(>5 cm)caused the compression of adjoining ribs, among them,1 disseminated disease had rib destruction which indicated malignant transformation. Conclusion:Specific CT imag-ing manifestations of chest wall schwannoma are available. The correct diagnosis is dependent on pathology.
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