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目的分析颈部恶性血管外皮瘤MRI表现,旨在提高对该病的认识。方法回顾性分析4例经病理证实的颈部恶性血管外皮瘤,并结合文献分析颈部恶性血管外皮瘤的MRI表现特点。所有患者均行MRI平扫及增强扫描。结果 4例恶性血管外皮瘤主要位于颈后肌群深部,呈类圆形较大肿块,最大径为63~114 mm,界限欠清晰,边缘呈分叶状。肿瘤包膜不完整,T1WI、T2WI均呈低信号,包膜向内延伸为低信号纤维分隔。肿瘤实质以等T1稍长T2信号为主,瘤内信号不均匀,4例病灶内见“蚯蚓”状血管流空无信号影;增强扫描4例病灶实质显著强化,信号欠均匀,病灶内的出血、坏死、囊变区无强化;肿瘤侵及多组深部肌群,沿肌间隙生长,并侵及邻近颈椎棘突、椎板等致使骨皮质变薄、部分不连续,骨质内呈现斑片状中度强化信号改变。1例出现肺内多发转移瘤,余3例未见远处淋巴结或器官转移。结论 MRI检查是颈部恶性血管外皮瘤的一种有效的诊断方法,为临床的进一步治疗提供可靠的影像依据。
Objective To analyze the MRI findings of cervical malignant hemangiopericytoma with the purpose of raising awareness of the disease. Methods Four cases of pathologically confirmed cervical malignant hemangiopericytoma were retrospectively analyzed. The MRI findings of cervical malignant hemangiopericytoma were analyzed. All patients underwent MRI plain scan and enhanced scan. Results The 4 cases of malignant hemangiopericytoma mainly located in the deep part of the posterior cervical muscle group. They showed a large circular mass with a maximum diameter of 63-114 mm. The boundaries were not clear and the lobes were lobulated. Incomplete tumor capsule, T1WI, T2WI showed a low signal, the inward extension of the capsule to a low signal fiber separation. The tumors were mainly T1 slightly longer T2 signal, the tumor signal was not uniform, and in 4 lesions, there was no signal flow of “earthworm” blood flow in empty space. In 4 cases of enhanced scanning, the lesions were significantly enhanced, the signal was not uniform, The hemorrhage, necrosis and cystic area were not strengthened. The tumor invaded the deep muscle group of multiple groups and grew along the interspace of the muscle and invaded adjacent spinous processes of the cervical vertebra, lamina, etc., resulting in the cortical bone becoming thinner and partially discontinuous. Showing patchy moderate enhanced signal changes. 1 case of multiple lung metastases, more than 3 cases no distant lymph nodes or organ metastases. Conclusion MRI is an effective diagnostic method for cervical malignant hemangiopericytoma and provides a reliable imaging basis for further clinical treatment.