CAJ | 학술논문

目的探讨肾上腺外神经节细胞瘤（GN）的CT特征，以提高对该病的认识和诊断水平。资料与方法回顾性分析13例经手术、病理证实的肾上腺外GN的CT表现，并与病理结果进行对照。结果13例肾上腺外GN患者中2例位于颈部，4例位于后纵隔，4例位于腹膜后，2例位于骶前，1例位于肾门区。肿块边界清晰，2例病灶呈圆形，3例呈类圆形，8例呈不规则形。不规则形中，6例呈塑形生长，包绕或推移周围血管，但血管形态正常，无侵犯征象；2例侵及椎间孔。CT平扫肿块密度低于肌肉，密度均匀4例，不均匀9例，其中2例病灶内见点状钙化。增强扫描5例病灶无强化，8例病灶动脉期轻度强化，静脉期及延迟期轻至中度持续强化。镜下示肿瘤含大量黏液基质，其间散在神经纤维细胞、胞质丰富的节细胞和毛细血管。结论肾上腺外GN的CT表现具有一定的特征性，与病理特点有较好的相关性，有助于诊断和鉴别诊断。
목적탐토신상선외신경절세포류（GN）적CT특정，이제고대해병적인식화진단수평。자료여방법회고성분석13례경수술、병리증실적신상선외GN적CT표현，병여병리결과진행대조。결과13례신상선외GN환자중2례위우경부，4례위우후종격，4례위우복막후，2례위우저전，1례위우신문구。종괴변계청석，2례병조정원형，3례정류원형，8례정불규칙형。불규칙형중，6례정소형생장，포요혹추이주위혈관，단혈관형태정상，무침범정상；2례침급추간공。CT평소종괴밀도저우기육，밀도균균4례，불균균9례，기중2례병조내견점상개화。증강소묘5례병조무강화，8례병조동맥기경도강화，정맥기급연지기경지중도지속강화。경하시종류함대량점액기질，기간산재신경섬유세포、포질봉부적절세포화모세혈관。결론신상선외GN적CT표현구유일정적특정성，여병리특점유교호적상관성，유조우진단화감별진단。
Purpose To explore the CT features of extra-adrenal ganglioneuroma (GN), and to improve the diagnostic accuracy of the disease. Materials and Methods CT features of 13 patients with extra-adrenal GN confirmed by surgical pathology were retrospectively analyzed, and compared with pathological findings. Results Two of 13 lesions were located in neck, four in posterior mediastinum, four in retroperitoneal space, two in front of sacrum, one in the region of renal hilus. All these masses were well defined, two appeared as round, three as oval, 8 as irregular shape. Of eight cases with irregular shape, six lesions presented a tendency of wedging into the space encasing and lapsing the vessel, with no evidence of invasion of the surrounding organs or vessels. Two tumors grew along the vertebrae and invaded intervertebral foramen. On plain CT imagings, the attenuations of the tumors were less than that of muscle, the masses with homogeneous and nonhomogeneous density were found in four and nine cases, respectively. Two patients associated with scattered and patchy cafilication. After contrast administration, eight lesions showed inhomogeneous enhancement:slight enhancement were seen in the arterial phase and gradually more strong enhancement during the portal venous and delayed phase. Enhancing lines or patchy were observed inside these tumors. Pathologically, the tumors appeared on a large amount mucus background, a few of scattering or nesting ganglion cells were distributed in many mature spindle cells, which lined in weave or fasciculation. Conclusion CT manifestations of extra-adrenal GN have certain characteristics, which are correlated closely with pathological features, therefore is helpful for the diagnosis and differential diagnosis.