Objective To assess the CT and MRI features of plexiform neurofibromas (PNF) in the head and neck. Methods CT (6) and MRI (10) of 15 patients with pathologically proven PNF in the head and neck were analyzed retrospectively. Results Of 17 PNF, 7 were located in the scalp (5) skin and subcutaneous tissue (2), and 10 invaded deep soft tissues of the maxillofacial re-gion. The superficial PNF had uniform CT density similar to that of muscle, uniform T1 isointensity and slight T2 hyperintensity with some fat signal intensities and small vessels within the lesions showing moderate enhancement. The 10 invasive PNF had beaded or stripe shapes, heterogeneous CT attenuation slightly lower than that of muscle, T1 isointensity, mixed T2 hypo-and hyperintensities with target appearance in some. Enhancement was mild on CT, mild-moderate on MRI. Conclusion Superficial and invasive PNF in the head and neck have characteristic CT and MRI features.%目的 探讨头颈部丛状神经纤维瘤的CT和MRI表现,以提高对丛状神经纤维瘤的认识.方法 回顾性分析经病理确诊的头颈部丛状神经纤维瘤15例,分析其CT和MRI表现.15例中5例行CT检查,9例行MRI检查,1例同时行CT和MRI检查.结果 15位患者共17例丛状神经纤维瘤,7例为表浅型,病灶位于皮肤及皮下脂肪层,边界清楚;10例为侵袭型,同时累及皮肤、皮下脂肪层及脂肪层深面的软组织,边界不清.表浅型多位于头皮区(n=5),病灶与肌肉呈等密度,MRI呈T1WI等T2WI稍高信号,内夹杂脂肪信号,增强轻至中度强化,内可见被包绕的纤细血管影;侵袭型病灶多位于颌面部(n=10),呈串珠状、索条状分布,CT呈不均匀较低密度,MR T1WI呈不均匀等信号,T2WI呈稍高或高信号,可伴有"靶征".CT增强肿瘤强化不明显,MRI增强中度至明显不均匀强化.结论 头颈部丛状神经纤维瘤多为表浅型和侵袭型,位于头皮者多为表浅型,位于颌面部者多为侵袭型,表浅型与侵袭型病灶CT及MRI表现不同.
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