病例一
病例二
锐角征
轴位CT平扫或增强扫描,位于脑桥小脑三角(cerebellopontineangle,CPA)的轴外占位,以内听道口为中心,并与岩骨之间的夹角为锐角,称为锐角征。
AxialCTplainscanorcontrastivescanislocatedinthecerebellOpontineAngle(CPA),withtheauditorycanalasthecenterandtheAnglebetweenitandthepetrosalboneasacuteAngle,whichiscalledacuteAnglesign.
锐角征是听神经瘤(acousticneurinoma,AN)在CT及MR上相对特征性的表现。听神经瘤起源于内听道内前庭神经的Schwann细胞,开始多局限在内听道内,随后沿着神经向阻力较小的内听道外及CPA生长。病变中心绝大多数位于内听道口,以窄基底与岩骨相贴,以致肿瘤与岩骨间的夹角为锐角。
AcuteAnglesignisarelativelycharacteristicmanifestationofacousticneurinoma(AN)onCTandMR.AcousticneuromaoriginatesfromSchwanncellsinthevestibularnerveoftheinnerauditorycanal,andbeginstobemostlyconfinedwithintheinnerauditorycanal,andthengrowsalongthenervetotheouterauditorycanalwithlessresistanceandCPA.Mostofthelesioncentersarelocatedintheinnerauditorycanal,andthenarrowbaseisattachedtotherockbone,sothattheAnglebetweenthetumorandtherockboneisacute.
听神经瘤是CPA区最常见的肿瘤,占该部位肿瘤的70%-80%,好发于中年人,女性略多于男性,95%单侧发病,双侧发病为神经纤维瘤病Ⅱ型,约占5%。绝大多数听神经瘤起源于前庭神经,起源于蜗神经者较罕见。前庭神经在内听道内分2支,即前庭上神经与前庭下神经,两支皆可发病,故又称前庭神经鞘瘤。
AcousticneuromaisaCPAareaofthemost