CAJ | 학술논문

目的：探讨不典型神经鞘瘤的临床影像学表现特点。方法回顾分析44例经病理学诊断的不典型神经鞘瘤的CT和MRI表现。结果CT表现为类圆形或分叶状低密度或等低混杂密度灶，绝大多数（38/40）边界清楚，其中实性肿瘤17例，囊实性病灶19例，单纯囊性病灶4例。CT增强扫描肿瘤实质呈渐进性不均匀强化。囊性病灶内存在强化程度不一的结节灶可能是囊实性神经鞘瘤较为特征性的表现。实性病灶呈“同心圆样”强化可能是实性神经鞘瘤比较有价值的征象。MRI上肿瘤实质部分呈稍长T1稍长T2信号，囊性部分呈长T1长T2信号，病灶周围可见水肿信号；“靶征”是特征性的MRI表现。结论不典型神经鞘瘤可发生在身体任何部位，熟悉其影像学特点对诊断很有帮助。
목적：탐토불전형신경초류적림상영상학표현특점。방법회고분석44례경병이학진단적불전형신경초류적CT화MRI표현。결과CT표현위류원형혹분협상저밀도혹등저혼잡밀도조，절대다수（38/40）변계청초，기중실성종류17례，낭실성병조19례，단순낭성병조4례。CT증강소묘종류실질정점진성불균균강화。낭성병조내존재강화정도불일적결절조가능시낭실성신경초류교위특정성적표현。실성병조정“동심원양”강화가능시실성신경초류비교유개치적정상。MRI상종류실질부분정초장T1초장T2신호，낭성부분정장T1장T2신호，병조주위가견수종신호；“파정”시특정성적MRI표현。결론불전형신경초류가발생재신체임하부위，숙실기영상학특점대진단흔유방조。
Objective To explore clinical imaging characters of atypical schwannoma .Methods CT and MR imagings of 44 cases of atypical schwannoma confirmed pathologically were retrospectively analysed .The lesions’ site of the 44 cases distributed in head and neck in 18 ,thoracic in 10 ,abdomen in 10 ,and other parts in 6 .40 cases were performed plain CT scan and 24 out of those were performed enhanced scan .10 cases were performed plain MR scan and 6 enhanced scan .Re-sults CT demonstrated that lesions were round or lobular mass with low or low-isodensity .Most of the lesions (38/40) had distinct boundary .There were 17 solid lesions ,19 cystic-solid lesions and 4 cystic lesions .Parenchyma of the lesions presented gradual enhancement after contrast and varying degree of the enhanced nodes within a cystic lesion was charac-teristic for schwannoma .Concentric circle like enhancement of solid lesions was a valuable sign of schwannoma .On MRI , the Parenchyma of schwannoma appeared slight long T1 and slight long T2 signal ,the cystic parts of the lesions showed long T1 and long T2 signal .Edema could be found around the lesions and‘target sign’ was specific for diagnosis on MRI . Conclusion Atypical schwannoma can be found in any site of the body .Being familiar with the imaging characters is help-ful for diagnosis .