脑叶室管膜瘤与脑室室管膜瘤的临床对比分析  

Differences in Clinical and Radiological Characteristics be-tween Intraparenchymal and Intraventricular Ependymoma

作　　者：高宜录[1] 邓传宗[1] 顾志凯[1] 陈建[1] 陈长[1] 刘道坤[1] 

机构地区：[1]南通医学院附属医院神经外科,江苏南通226001

出　　处：《中国神经肿瘤杂志》2003年第2期94-97,共4页Chinese Journal of Neuro-Oncology

摘　　要：一般认为脑叶室管膜瘤和脑室室管膜瘤是发生于脑不同部位的同一性质的肿瘤,但是在临床工作中发现它们之间似乎存在差异;再之,脑室室管膜瘤由于生长部位、CT和MRI的特点术前多能作出正确的诊断,而脑叶室管膜瘤因发生部位不同,影像学表现有很大差异,术前确诊较为困难。本研究目的是从临床角度探讨它们之间的差异,并探讨脑叶室管膜瘤的影像学特点。方法:收集手术治疗室管膜瘤105例,其中脑叶内室管膜瘤35例,脑室内室管膜瘤65例。将脑叶室管膜瘤和脑室室管膜瘤两组临床资料进行对比分析。结果:发现脑室室管膜瘤多见于男性儿童和青年(<40岁占70.77%,男:女=2.14:1),以恶性室管膜瘤居多(52.94%)。而脑叶室管膜瘤则多见于中老年(>40岁占62.86%),无性别差异(男:女=1.05:1),以室管膜瘤占多数(65.38%),术前CT和MRI正确诊断者少(9.52%)。结论:脑叶室管膜瘤和脑室室管膜瘤有不同的临床特点,提示两者在发生和发展上可能存在着不同。脑叶室管膜瘤CT和MRI误诊率高,充分认识脑叶室管膜瘤CT和MRI的特点,有利于提高脑叶室管膜瘤的术前诊断率。BACKGROUND & OBJECTIVE: Intraparenchymal and intraventricular ependymomas were traditionally considered as identical tumors. However, the clinical presentation and progress were quite different be-tween them. Moreover, intraventricular ependymoma has a number of characteristic features on CT and MRI scan; therefore it is easier to predict the correct pathology before surgery. On the other hand, intraparenchymal ependymo-ma is more difficult to differentiate from other primary brain tumors. In this study, we tried to find out the differ-ences in clinical and radiological characteristics between these two types of tumors. METHODS: We reviewed our series of 105 patients with ependymoma. Thirty-five of them were intraparenchymal, 65 were intraventricular and other 5 were spinal cord ependymomas. The differences in clinical and radiological findings of intraparenchymal and intraventricular ependymomas were reviewed. RESULTS: Among the patients with intraventricular ependymo-mas, 70.8% were children and young people(<40 year) . The male to female ratio was 2. 1: 1. Moreover,53.0% were malignant. On the contrary, among the patients with intraparenchymal ependymomas, only 37. 1% were younger than 40-year-old. And only 34. 6% were malignant. Moreover, the correct diagnosis of intraparenchy- mal ependymoma based on CT and MRI were made only in 9.5% of the patients before surgery. CONCLUSION: The clinical and radiologi-cal features of intraventricular and intraparenchy-mal ependymomas were different. Intraventricu-lar ependymoma occur more commonly in younger patients and more were likely to be malignant. This suggests that their origin and progression characteristics may be different. There are certain characteristics on CT and MRI for intraparenchymal ependymomas that help in making the correct diagnosis before surgery.

关 键 词：室管膜瘤 临床分析 病理学 磁共振成像 计算机断层扫描 

分 类 号：R739.4[医药卫生—肿瘤]