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Abstract：
OBJECTIVE: To investigate the differences of pathological, radiological, and prognostic features between cellular schwannoma (CS) and non-cellular schwannoma (NCS).
METHODS: CT and MRI images of 24 patients with CSs and 30 patients with NCSs were reviewed retrospectively. Clinico-pathological characteristics of CSs and NCSs and tumor radiological features including location, shape, size, border, cystic-solid components, hemorrhage, calcification, bone remodeling, pattern of CT/MRI precontrast scan, degree of enhancement, target sign, and tumor vessels were recorded. Statistical analyses were performed with Chi square or Fisher\'s exact test, independent sample t test, and logistic regression analysis to compare the differences between CSs and NCSs.
RESULTS: Four CSs showed mitotic activity, which was not found in the NCS group (P = 0.034). The CS group showed higher MIB-1 index than that in the NCS group (P = 0.002). Two patients with CS presented with tumor recurrence. Compared to NCSs, CSs were often located in spinal area (P = 0.028) and irregular (P = 0.013) with larger size (P = 0.005). Target sign, a common finding in NCSs (7/22, 31.8 %), was not seen in CSs (P = 0.014). The tumor vessels were only seen in CS group (4/22, 18.2 %; P = 0.027). Regression analysis revealed that location (P = 0.048) and size (P = 0.012) were independent indicators in differentiating CSs from NCSs.
CONCLUSIONS: CS is a rare subtype of schwannoma with some significant radiological features including a predilection for the spinal area, irregular shape, large tumor size, absent target sign, tumor vessels, and potential risk of recurrence. Location and size of the schwannomas were the most useful indicators in differentiating CSs from NCSs.
METHODS: CT and MRI images of 24 patients with CSs and 30 patients with NCSs were reviewed retrospectively. Clinico-pathological characteristics of CSs and NCSs and tumor radiological features including location, shape, size, border, cystic-solid components, hemorrhage, calcification, bone remodeling, pattern of CT/MRI precontrast scan, degree of enhancement, target sign, and tumor vessels were recorded. Statistical analyses were performed with Chi square or Fisher\'s exact test, independent sample t test, and logistic regression analysis to compare the differences between CSs and NCSs.
RESULTS: Four CSs showed mitotic activity, which was not found in the NCS group (P = 0.034). The CS group showed higher MIB-1 index than that in the NCS group (P = 0.002). Two patients with CS presented with tumor recurrence. Compared to NCSs, CSs were often located in spinal area (P = 0.028) and irregular (P = 0.013) with larger size (P = 0.005). Target sign, a common finding in NCSs (7/22, 31.8 %), was not seen in CSs (P = 0.014). The tumor vessels were only seen in CS group (4/22, 18.2 %; P = 0.027). Regression analysis revealed that location (P = 0.048) and size (P = 0.012) were independent indicators in differentiating CSs from NCSs.
CONCLUSIONS: CS is a rare subtype of schwannoma with some significant radiological features including a predilection for the spinal area, irregular shape, large tumor size, absent target sign, tumor vessels, and potential risk of recurrence. Location and size of the schwannomas were the most useful indicators in differentiating CSs from NCSs.
摘要：
目的：探讨病理变化的差异，放射学,细胞性神经鞘瘤（CS）和非细胞性神经鞘瘤（NCS）的预后特征。
方法：对24例CSs和30例NCSs的CT和MRI图像进行回顾性分析。CSs和NCSs的临床病理特征和肿瘤放射学特征，包括位置，形状,尺寸,边界,囊性固体成分，出血,钙化,骨重塑,CT/MRI造影前扫描模式，增强程度,目标标志,并记录肿瘤血管。统计分析采用卡方检验或Fisher精确检验，独立样本t检验，和logistic回归分析比较CSs和NCSs之间的差异。
结果：四个CSs显示有丝分裂活性，在NCS组中未发现（P=0.034）。CS组MIB-1指数高于NCS组(P=0.002)。2例CS患者出现肿瘤复发。与NCS相比，CSs通常位于脊柱区（P=0.028）和不规则（P=0.013），较大（P=0.005）。目标标志,NCSs中的一个常见发现(7/22，31.8%)，在CSs中未见到（P=0.014）。肿瘤血管仅见于CS组(4/22,18.2%;P=0.027)。回归分析显示，位置（P=0.048）和大小（P=0.012）是区分CSs和NCSs的独立指标。
结论：CS是一种罕见的神经鞘瘤亚型，具有一些重要的放射学特征，包括对脊柱区域的偏爱，不规则形状,大肿瘤大小，缺少目标信号,肿瘤血管,和潜在的复发风险。神经鞘瘤的位置和大小是区分CSs和NCSs的最有用指标。
方法：对24例CSs和30例NCSs的CT和MRI图像进行回顾性分析。CSs和NCSs的临床病理特征和肿瘤放射学特征，包括位置，形状,尺寸,边界,囊性固体成分，出血,钙化,骨重塑,CT/MRI造影前扫描模式，增强程度,目标标志,并记录肿瘤血管。统计分析采用卡方检验或Fisher精确检验，独立样本t检验，和logistic回归分析比较CSs和NCSs之间的差异。
结果：四个CSs显示有丝分裂活性，在NCS组中未发现（P=0.034）。CS组MIB-1指数高于NCS组(P=0.002)。2例CS患者出现肿瘤复发。与NCS相比，CSs通常位于脊柱区（P=0.028）和不规则（P=0.013），较大（P=0.005）。目标标志,NCSs中的一个常见发现(7/22，31.8%)，在CSs中未见到（P=0.014）。肿瘤血管仅见于CS组(4/22,18.2%;P=0.027)。回归分析显示，位置（P=0.048）和大小（P=0.012）是区分CSs和NCSs的独立指标。
结论：CS是一种罕见的神经鞘瘤亚型，具有一些重要的放射学特征，包括对脊柱区域的偏爱，不规则形状,大肿瘤大小，缺少目标信号,肿瘤血管,和潜在的复发风险。神经鞘瘤的位置和大小是区分CSs和NCSs的最有用指标。
