| Objective:To evaluate the imaging CT of abdominal neurogenic tumors retro spectively,And investigate the features of CT diagnose differential diagnosis.Methods:Collect 127 cases of abdominal neurogenic tumors in our hospital from January 2011 to May 2015 confirmed by pathology,a total of 138 lesions.Including male 64, female 63, age from 2 months to 70 years old. All cases were performed CT plain scan and enhanced scan.Scan range from the diaphragm to the pelvis, thickness 2mm, interval 2mm, after injection of contrast agenting for multi phase scanning.Obserde CT imaging findings with PACS,including tumor distribution, number, shape, size, edge, density, calcification, measurement of plain and enhanced CT values, etc.All data applications SPSS22.0 statistical software for analysis.Results:Type of tumor:The group of 127 cases(138 lesions) of abdominal nerogenic tumors included 17 cases of schwannoma,2 cases of nerofibroma,ganglion cells neroma in 14 cases,neuroblastoma cells in section 6 cases,24 cases of neuroblastoma,12 cases of paraganglioma and 51 cases of pheochromocytoma.Among them,39 cases were malignant,30.7% were benign and 88 cases were benign, accounting for 69.3%.Distribution of tumor:In this group,the neurogenic tumors distribution of which 71.74% (99/138)is located in adrenal gland,21.02% in retroperitoneal,3.62%(5/138) in abdominal cavity and 3.62% in the stomach..Located in the adrenal lesions is given priority to with pheochromocytoma 63.64%(63/99) and higher the other tumors in adrenal distribution.Nerve sheath tumor accounted for 29.41% (5/17) in the wall of the stomach.Sex and age:The comparison of sex and age of this common set of the neurogenic tumors showed gender disribution was not statistically signifcant different (X2 test,P> 0.05); Ganglion cells neuroma, ganglioneuroblastoma and neuroblastoma patients were younger than schwannoma, pheochromocytoma and accessory nerve tumors.The differences were statistically signifcant (rank and inspection,P< 0.01).Tumor morphology:Neurilemmoma and neuroblastoma cells, neuroblastoma and pheochromocytoma morphological in comparison, the difference has statistical significance (X2 test, P< 0.05).Other forms of tumor in comparison were not statistically significant (X2 test, P> 0.05).Margin of tumor:Comparison of borderlines of 7 kinds of neurogenic tumors showed neurogenic tumor lesions’edge unclear higher than other neurogenic tumors,The differences were statistically significant (P< 0.05).Other margin of tumor in comparison were not statistically significant (X2 test, P> 0.05).Sizes of tumor:The common neurogenic tumor lesion length diameter ratio, the maximum length of neuroblastoma diameter 8.92cm, followed by the average length of neurofibroma diameter 8.80cm, ganglion mother cell tumor size 8.45cm, ganglioneuroma long diameter 7.46cm. The average length of schwannoma diameter 5.76cm, addicted to slenderness 5.27cm chromaffin cells, the average length of paraganglioma diameter 6.93cm.Comparison of sizes of 6 kinds of neurogenic tumors showed neurogenic tumor lesions were bigger than those with schwannoma and pheochromocytoma, the difference had statistical significance (P< 0.05).CT value and enhancement rate of tumor plain scan:Comparison of Plain and enhanced CT scan on the kinds of neurogenic tumors showed schwannoma tumor’s lesion plain CT scan lower than other neurogenic tumors scan CT value,the differece was statistically sighificant (P< 0.05). Arterial enhancement rate of pheochromocytoma is higher than the ganglion cell tumor and neuroblastoma tumors’arterial enhancement rate, the paraganglioma of arterial enhancement rate is also higher than the ganglion cell tumors’, the difference is statistically significant (rank and inspection, P< 0.05);Venous phase increase rate of pheochromocytoma is higher than the ganglion cell tumor venous phase increase rate, the difference is statistically significant (rank and inspection, P< 0.05); Delay increase rate of schwannomathe is higher thandelay increase rate of pheochromocytoma, the difference is statistically significant (anova, P< 0.05).Tumor calcification:Neuroblastoma is hihger than schwannoma in calcification, accessory nerve tumor and pheochromocytoma, the difference is significant (X2 test, P< 0.01); ganglioneuroma has calcified lesions was higher than that of pheochromocytoma, the difference has statistical significance (X2 test, P< 0.05).Necroses and liquefaction:Neuroblastoma tumors’ necrosis and cystic were higher than Schwannoma, ganglion cells neuroma and pheochromocytoma. Ganglion cells neuroma tumors’were higher than pheochromocytoma and schwannoma tumors’.the difference has statistical significance (X2 test, P< 0.05).Pathological blood vessel:Among 138 abdominal nerve tumor lesions,21 tumor lesions had large vessels neuroblastoma accounted for 57.14%(12/21).(2 paraganglioma,2 ganglion cell neuroblastoma,12 neuroblastoma,5 pheochromocytoma), Benign and malignant neurogenic tumors’edge of the lesion, shape, calcification, tumor vascular necrosis, cystic, liquefied and diameter size like a statistically significant difference.21 cases of preoperative and metastatic lesions in malignant tumor, accounting for 53.8%.In 24 cases of neuroblastoma,18 neuroblastoma tumors can be obviously found with metastatic lesions,6 cases were not seen metastatic lesions.6 Ganglion tumor cases,2 cases found metastatic lesions.Conclusion:1、Abdominal neurogenic tumors are good hair at adrenal and retroperitoneal benign tumor, Benign tumor is given priority to with paraganglio ma, but malignant tumor is given priority to with neuroblastoma. CT in the local ization diagnosis has higher value.2^ Neurogenic tumors are usually expressed as morphological rules, and the soft tissue masses with clear margins,Schwannomas and pheochromocytoma are seen with cystic change.Neuroblastoma and ganglion cells neuroblastoma esions had amaximal diameter more than 5cm,irregular shape and showed calcification density, childish pathological blood vessel,the embedding abdominal aorta or renal artery, and common metastatic lesions. Schwannoma and ganglion cell tumor common showde punctate calcification;Pheochromocytoma and paraganglioma enhance performance for rapid continuous reinforcement.Neurilemmoma often showed continued enhancement, delayed enhancement is most obvious.2、Including neuroblastoma, ganglion neuroblastoma, malignant pheochromocytoma, malignant schwannoma and malignant paraganglioma, Malignant neurogenic tumor in CT is often shown as the edge is not clear, irregu lar and patchy calcification, liquefaction and necrosis and vascular pathology an d cystic change rare length to diameter larger than the 5cm. |
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