目的:总结分析外周恶性神经鞘膜瘤的影像学表现,提高鉴别诊断能力.方法:回顾性分析11例经手术或病理证实的恶性神经鞘膜瘤的影像学表现,并与手术病理对照分析,11例中行CT检查3例,行MRI检查4例,CT和MRI均检查4例.结果:CT平扫表现为等、低混合密度软组织肿块影,形态不规则,病灶边缘较光整2例,边缘毛糙5例.CT增强扫描呈不均匀强化,坏死区不强化,网格样强化2例,不均匀强化5例.T1WI呈等、略低信号,内见局灶性长T1信号影；T2 WI序列以略高信号为主,内见局灶性长T2信号,周围软组织见片状浸润高信号；MRI增强扫描呈不均匀强化.结论:恶性外周神经鞘膜瘤的CT和MRI表现具有一定的特征性.%Objective:To review the imaging appearances of malignant peripheral nerve sheath tumors (MPNST) in order to improve its diagnostic accuracy. Methods: The imaging appearances of 11 cases with surgery and pathology proved MPNST were retrospectively studied and correlated with surgery and pathology. Of the 11 patients,3 patients had CT,4 patients had MRI and 4 patients had both of the two. Results: The CT appearances included iso/hypo-attenuated soft tissue mass with irregular contour,2 lesions had relatively smooth margin,and 5 lesions were ill-defined. Heterogeneous enhancement was assessed with network-like enhancement in 2 patients and heterogeneous enhancement in 5 patients. The MRI appearances showed iso-/slight hypo-intensities with focal long T1 signal intensity on T1WI, mainly slight high signal intensity with focal long T2 signal areas on T2 WI,hyper-intense infiltration of the adjacent soft tissue could also be revealed. Heterogeneous enhancement was showed after Gadolinium administration. Conclusion: Certain CT and MRI characteristics of MPNSTs could be revealed.
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