Sonographic Differentiation Between Schwannomas and Neurofibromas in the Musculoskeletal System
Sonographic Differentiation Between Schwannomas and Neurofibromas in the Musculoskeletal System
复制标题
DOI：
10.7863/ultra.15.01067
复制
发表时间：
2015-12-01
影响因子：
2.3
通讯作者：
Shin, Myung Jin
中科院分区：
文献类型：
--
作者：
Ryu, Jeong Ah;Lee, Sang Hoon;Shin, Myung Jin
Objectives本研究的目的是确定关键功能，并确定一个战略之间的区别神经鞘瘤和神经纤维瘤using sonography.Methods这一回顾性研究是由机构审查委员会在我们医院批准，并放弃知情同意。我们回顾了病理证实的神经鞘瘤和神经纤维瘤的四肢和体壁的超音波。在灰度图像上，根据肿瘤的大小、最大与最小直径比、形状、轮廓、边缘、位置、包膜、回声、回声质地、囊性变化、瘤内钙化的存在、靶征的存在以及进入或离开神经的存在来评价肿瘤。如果确定了进入或退出神经，则表征神经-肿瘤位置和神经-肿瘤过渡。在彩色多普勒图像上，评估血管的存在和数量。连续变量（肿瘤大小、最大直径与最小直径之比、年龄）采用t检验，分类变量采用χ 2检验和Fisher精确检验。结果共纳入146例经病理证实的肿瘤，其中神经鞘瘤115例，神经纤维瘤31例。神经鞘瘤与神经纤维瘤的最大直径、最大直径与最小直径之比、轮廓、囊性部分、神经-肿瘤位置、神经-肿瘤过渡和血管分布存在显著差异（P <0.05），当考虑预测模型时，分叶状轮廓、梭形和血管分布不足的神经纤维瘤有助于鉴别。神经-肿瘤的位置、神经-肿瘤的转移、最大直径与最小直径的比值在各组间也有显著性差异（P <0.05），因此对神经源性肿瘤的鉴别诊断有一定的帮助。结论超声检查有助于神经鞘瘤和神经纤维瘤的鉴别诊断。
Objectives The purpose of this study was to determine key features and define a strategy for differentiation between schwannomas and neurofibromas using sonography.Methods This retrospective study was approved by the Institutional Review Board at our hospital, and informed consent was waived. We reviewed sonograms of pathologically proven schwannomas and neurofibromas of the extremities and body wall. On grayscale images, tumors were evaluated on the basis of their size, maximum-to-minimum diameter ratio, shape, contour, margin, location, encapsulation, echogenicity, echo texture, cystic changes, presence of intratumoral calcifications, presence of a target sign, and presence of an entering or exiting nerve. If an entering or exiting nerve was identified, the nerve-tumor position and nerve-tumor transition were characterized. On color Doppler images, the presence and amount of vascularity were evaluated. Student t tests were used for analysis of continuous variables (size, maximum-to-minimum diameter ratio, and age); chi(2) and Fisher exact tests were used for analysis of categorical variables.Results A total of 146 pathologicallyproven tumors, including 115 schwannomas and 31 neurofibromas of the extremities and body wall, were included. The maximum diameter, maximum-to-minimum diameter ratio, contour, cystic portion, nerve-tumor position, nerve-tumor transition, and vascularity were significantly different in schwannomas versus neurofibromas (P < .05), and a lobulated contour, fusiform shape, and hypovascularity of netrofibromas could be helpful for differentiation when a prediction model is considered. The nerve-tumor position, nerve-tumor transition, and maximum-to-minimum diameter ratio were also significantly different between groups (P < .05) and thus could be useful for differentiation of neurogenic tumors.Conclusions Sonographic findings are helpful in differentiating between schwannomas and neurofibromas.