Stull M A, Moser R P, Kransdorf M J, Bogumill G P, Nelson M C
Department of Radiology, Georgetown University Medical Center, Washington, DC.
Skeletal Radiol. 1991;20(1):9-14. doi: 10.1007/BF00243714.
Magnetic resonance imaging (MRI) was used to evaluate 22 histologically proven peripheral nerve sheath tumors, approximately two-thirds of which arose in the lower extremity. The histologic distribution was as follows: 12 schwannomas, 7 neurofibromas, and 3 malignant peripheral nerve sheath tumors (2 of which occurred in patients with neurofibromatosis). Most lesions demonstrated an intermediate to moderately bright signal on T1-weighted images and were minimally inhomogeneous. All lesions were moderately bright on proton-density-weighted images and bright on T2-weighted images, again with variable inhomogeneity. The extent of the tumor was best assessed on proton-density- and T2-weighted images. Smooth margins were noted in 19 lesions. Of the 3 remaining lesions, 2 were malignant (but had been subjected to biopsy prior to MRI), and the other lesion was a plexiform neurofibroma. MRI accurately determined the relationship between the lesion and the adjacent neurovascular structures and muscles, thereby assisting surgical management. On MRI, 5 lesions demonstrated coexistent subtle muscle atrophy along the longitudinal axis of surrounding or distally innervated musculature. This latter finding, together with the presence of a tumor in the vicinity of a large nerve trunk, suggests a peripheral nerve sheath neoplasm.
磁共振成像（MRI）用于评估22例经组织学证实的周围神经鞘瘤，其中约三分之二发生于下肢。组织学分布如下：12例施万细胞瘤，7例神经纤维瘤，3例恶性周围神经鞘瘤（其中2例发生于神经纤维瘤病患者）。大多数病变在T1加权图像上表现为中等至中度高信号，且不均匀性最小。所有病变在质子密度加权图像上为中度高信号，在T2加权图像上为高信号，同样存在不同程度的不均匀性。肿瘤范围在质子密度加权和T2加权图像上评估最佳。19个病变边界光滑。其余3个病变中，2个为恶性（但在MRI检查前已接受活检），另一个病变为丛状神经纤维瘤。MRI准确确定了病变与相邻神经血管结构及肌肉之间的关系，从而辅助手术治疗。在MRI上，5个病变显示沿周围或远侧受支配肌肉组织的纵轴存在并存的轻微肌肉萎缩。后一发现，连同大神经干附近存在肿瘤，提示为周围神经鞘瘤。
