Correlative Analysis Of Ultrasound And Pathology Of Peripheral Neurogenic Tumors

Objective:Peripheral nerve tumor of sonographic features of different histological types of peripheral nerve tumor of Ultrasonographic basis of pathology, to reveal the different histological types of peripheral nerve tumor unique sonography, especially in nerve sheath tumors / neurofibromatosis and benign / malignant diagnosis, improve accuracy of preoperative ultrasonography for clinical diagnosis to provide a more reliable basis.Information:Select March 2006~ October 2009 China-Japan Unit Hospital, Jilin University. Inclusion criteria: preoperative ultrasound examination, were treated by surgery, was pathologically proven peripheral nerve tumor, surgery, ultrasonography and pathological findings were documented.Instrument:Select Siemens production of color Doppler ultrasonic diagnostic apparatus Acuson Sequoia 512, GE produced VIVID7. Superficial parts of selected linear probe, frequency 8 ~ 13MHz; abdominal or pelvic deeper parts of array probe inspection sudden choice, Frequency: 3.5 ~ 7.0MHz. Under specific circumstances lesion depth, gain, focus position, the image shows the best results. Method:Ultrasound: First of all two-dimensional observation of tumor site, size, shape, internal echo characteristics, observe whether the tumor around the nerve and the nerve trunk the existence and location of the form of relations and connections, and then follow the nerve in the anatomical lesions of moving vertical and horizontal and other multi-section scanning, real-time dynamic effects of nerve continuity, nerve sheath integrity and attention to its blood vessels, tendons and ligaments of the identification; CDFI, PW observe the distribution of tumor blood flow and internal features of the spectrum.Operation: Record the nature of the tumor, location, shape, envelope, and relations with the surrounding tissues and organs for detailed records.Pathology: Tumor tissues were fixed in 10% formalin, paraffin embedded, 3um thick slices, HE staining, different magnification optical microscope to observe the distribution of tumor cells, vascular proliferation, whether cystic, mucus or hyalinization, hemorrhage, collagen and the quantity of fibrous tissue, as detailed records.Analysis: The results of preoperative ultrasound compared with pathological findings to pathologic findings as the gold standard, summarized all kinds of peripheral nerve imaging characteristics of the source masses, statistical distribution of ultrasound indicators and determine the exact nature of tumor rate, positioning accuracy of tumor to determine tumor and adjacent tissues and organs of the important relationship between accuracy. SPSS10.5 statistical software used for data analysis, p <0.05 significant difference in measurement data using mean±standard deviation (X±S) said that the different histological types of neurogenic tumors t test was used to compare the age, gender differences in use ofχ2 test, different histological types of neurogenic tumors of the sonographic features were analyzed byχ2 test.Results:1,A case of this group took place in accordance with the tumor site is divided into three groups after the peritoneum (A group), physical neural stem (B), brachial plexus (C), cervical vagus nerve (D). Of clinical manifestations of each group in Table 3.1, the anteroposterior diameter of each tumor and the overall mean diameter is about to point estimates, with mean±1 standard deviation. A group B, C group compared the clinical performance of P <0.05, B group and C group compared clinical features of tumor P> 0.05, D group B, C clinical comparison group P <0.05).2,According to the different pathological types of cancer that is nerve sheath tumors (a group), neurofibroma (b group), malignant peripheral nerve sheath tumors (c group), access to patient gender, age distribution, sonographic characteristics, blood flow richness, frequency spectrum test results. Differences in gender distribution between men and womenχ2 test, P> 0.05, t test differences in age distribution, P> 0.05. a, b, c tumor size analysis of variance, F value of 0.477, P = 0.961; tumor capsule or without conditions a group and b, c group P <0.05, b group c group P> 0.05; a, b, c group compared internal echo of tumorχ2 test, P> 0.05; tumor cystic change within a group and c group P> 0.05, a, c group compared with b P <0.05; tumor posterior echo enhancement case a group b group P> 0.05, a, b group c group P <0.05. a group and b, c relatively rich blood group P <0.05, b group c group of relatively rich blood P <0.05, a group b group of relatively rich blood P> 0.05, c group and the a, b group of relatively rich blood flow P <0.05.3,Three different types of tumor tissue is nerve sheath tumors, neurofibromas and malignant peripheral nerve sheath tumor histopathologic findings (1)All 40 cases of schwannoma tumor encapsulated, spindle-shaped or oval, cut surface off-white or greyish yellow shiny body soft. Tissue sections showed tumor cells in areas within the rich (AntoniA) and lack cell area (AntoniB) were distributed randomly staggered, 11 tumors AntoniA-based, 29 lesions were mixed. 25 patients with tumors rich in blood vessels. 31 cystic mass within the see. (2)Neurofibroma tumor in this group, 23 patients showed an oval, state clearly see only one case of incomplete capsule, no other coating, 4 cases pseudo-coated, rigid and tough and flexible, cut off-white , the quality really shows whirlpool fiber. Three cases of nerve sheath tumors see cells, mucus-like matrix of collagen fibers and were scattered in distribution, and the other 20 cases the tumor was surrounded by some obvious mucous degeneration, myxoid containing amorphous matrix, while the central part of a regional arrangement of close nerve sheath cells, nerve fibers and collagen fibers. (3)Malignant peripheral nerve sheath tumors in this group one case of oval-shaped, state yet clear, there is no complete capsule, more than irregular, ill-defined, non-coated structures. Gray fish-shaped cut surface, hemorrhage and necrosis were seen within the area. Microscopically, the tumor was malignant peripheral nerve sheath main component cells and Schwann cells, spindle-shaped tumor cell nucleus, large and small, there is obviously abnormal, showing megakaryocytes, tumor cells were arranged in interwoven cords, accompanied by bleeding inside.Conclusion:1,Ultrasonic tips around the source of neurogenic tumors of the organizations, more specifically, can be used as the preferred screening tool.2,Different histological types of peripheral nerve tumors of the performance of the sonographic characteristics. Whether the capsule swelling fast, whether cystic change, whether calcification, posterior echo enhancement, internal blood flow and vascular resistance index to differentiate nerve sheath tumor, neurofibroma, malignant peripheral nerve sheath tumor of the main signs.3, Neurogenic tumors of different histological types of the sonographic features and pathological manifestations of good correspondence between the basic research for the ultrasound diagnosis of pathology provides a strong theoretical basis.