摘要
目的总结面神经鞘瘤的CT和MRI表现,提高对其影像学特点的认识。方法回顾性分析9例经手术病理证实的面神经鞘瘤的影像学表现特点,9例均行MSCT平扫,3例行平扫加增强扫描,6例行MRI平扫加增强扫描。结果 9例面神经鞘瘤分别涉及内听道段1例、迷路段3例、膝状神经节5例、鼓室段6例、乳突段4例、腮腺段2例。CT表现:8例受累段面神经管扩大和/或骨质破坏,5例鼓室内软组织块影,4例听小骨外移和/或破坏,4例乳突区软组织块影伴外耳道后壁骨质破坏,2例茎乳孔扩大,2例腮腺内软组织肿块。MRI表现:6例肿瘤均表现为结节状或不规则状软组织肿块。T1WI呈等或等低信号,T2WI呈偏高信号,信号均匀或不均匀,增强后中等至明显强化,信号均为不均匀。结论一个肿瘤常涉及多个面神经节段,CT对显示肿瘤区骨质改变较佳,MRI可很好地显示面神经鞘瘤的部位、形态、范围和内部结构特征,两者结合有助于面神经鞘瘤的定性诊断及鉴别诊断,为临床制定手术方案提供依据。
Objective To summary the imaging features of various types of facial nerve schwannoma in order to improve the accuracy of diagnosis. Methods Nine cases of facial nerve schwannoma proved by surgery and pathology were collected￡The imaging findings of CT and MRI were retrospectively analyzed￡CT was performed in all 9 patients , in which 3 cases were used constrast media. Plain and enhanced MRI were performed in 6 cases. Results OF 9 cases, the tumors involved internal auditory canal （n=1） ,labyrinth segment （n=3）, geniculate ganglion （n=5）,tympanic segment （n=6） , mastoid segment （n=4） ,intra-parotid segment （n=2）.The CT findings included enlargement and/or destruction of facial nerve canal （n=8）, intra-tympanic cavity soft tissue mass （n=5）,destruction and/or lateral displacement of auditory ossicles （n=4）, enlargement of horizontal segmentin （n=2）, intra-parotid segment soft tissue mass （n=2）.The MRI findings of 6 patients were nodular of irregular soft tissue mass. Compared with the signal intensity of brain, MR images of the tumors always showed slightly low or isointense on T1-weighted images and isointense or slightly hyperintense on T2-weighted images.After contrast administration, heterogeneously moderate to marked enhancement could be assessed. Conclusion Multiple segments of the facial nerve could be involved by one facial nerve schwannoma.CT is superior in demonstrating the bony changes of facial nerve canal,MRI can accurately display the location ,shape ,extension and intratumoral structure of facial nerve schwannoma. CT in combination with MRI are helpful in the localization and differential diagnosis as well as provide significant information for surgical planning and approach.
出处
《中国CT和MRI杂志》
2010年第3期34-36,共3页
Chinese Journal of CT and MRI
