目的 探讨周围神经鞘瘤的超声表现及其诊断要点.方法 回顾性分析经手术和病理证实的43例共46个神经鞘瘤的超声表现,并结合MRI与病理进行对照研究.结果 45个神经鞘瘤表现为形态规则、边界清晰,仅1例位于C4神经根处的神经鞘瘤表现为形态不规则、边界不清,呈“哑铃状”.超声显示神经鞘瘤实性30个,囊实性15个,完全呈囊性1个,后方回声增强39个,靶征21个,鼠尾征23个,血管伴行征17个.神经鞘瘤内血流0级4个,Ⅰ级9个,Ⅱ级22个,Ⅲ级11个.超声显示靶征21个(21/46,45.6％),MRI显示靶征26个(26/46,56.5％),超声对神经鞘瘤内靶征的检出能力与MRI具有一致性(Kappa值=0.527,P＜0.001).超声诊断神经鞘瘤的准确率为73.9％(34/46).结论 超声对神经鞘瘤内靶征有较好的检出率,可为诊断神经鞘瘤提供新的依据.%Objective To investigate the ultrasonic appearance of peripheral neurilemmoma.Methods Ultrasonic appearances of 43 patients with 46 neurilemmomas confirmed by surgery and pathology were analyzed retrospectively and compared with their MRI and pathological features.Results Forty-five neurilemmomas were with regular shape and clear boundary,except one at the root of nerve C4 that was irregular in shape and unclear in boundary,like a " dumbbell".Sonography showed that there were 30 neurilemmomas displaying as solid tumors,15 as cystic and solid,and 1 as entirely cystic.Posterior echoenhancement,target sign,rat tail sign and vessels accompanying sign were found in 39,21,23 and 17 neurilemmomas,respectively.There were 4 neurilemmomas with ultrasound blood flow grade 0,9 with grade Ⅰ,22 with gradeⅡ,and 11 with grade Ⅲ.The target signs were found in 21 cases (21/46,45.6％) and 26 cases (26/46,56.5 ％) by ultrasound and MRI,respectively.The capability of ultrasound finding the target sign in neurilemmoma was comparable to MRI(Kappa =0.527,P ＜0.001).The diagnostic accuracy rate of neurilemmoma by ultrasonography was 73.9％(34/46).Conclusions The ultrasound has a relatively high detection of the target sign in neurilemmoma,which may provide a new basis for the ultrasonic diagnosis of neurilemmoma.
展开▼
