颅内血管外皮瘤的影像学诊断:9例回顾性总结  

Diagnostic Imaging Features of Intracranial Hemangiopericytomas: Review of 9 Cases

作　　者：万业达[1] 张云亭[1] 刘松龄[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052

出　　处：《中国神经肿瘤杂志》2004年第2期130-133,共4页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:颅内血管外皮瘤的影像学表现与脑膜瘤相似,鉴别诊断困难。本文通过分析颅内血管外皮瘤的CT、MRI和血管造影表现,探讨其影像学特征。材料和方法:回顾性分析9例经手术和病理学证实的颅内血管外皮瘤患者的影像学资料。9例均行CT平扫,4例行CT增强,7例行MRI平扫和增强检查,2例行全脑血管造影。结果:肿瘤位于前颅窝2例、中颅窝3例、后颅窝3例、顶叶大脑镰旁1例;肿块直径5～8cm,呈分叶状,并与脑膜广基相连,肿瘤周围有水肿伴占位效应,肿块内可见囊变和坏死区。CT平扫肿瘤均为高密度为主的混杂密度影,2例有骨侵蚀,9例均无骨质增生和钙化。CT增强扫描,病灶明显强化。MRI平扫为等或长T_1稍长T_2信号为主的混杂信号影。注入对比剂后病灶明显强化。5例可见"脑膜尾征"。血管造影示肿瘤血供丰富,血供来自脑内、外血管。结论:当影像学上表现为以下3个特点时,应考虑颅内血管外皮瘤:(1)起自脑膜较大的分叶状、无钙化肿块,肿瘤有囊变及瘤周明显水肿;(2)CT及MRI增强检查时肿块明显强化;(3)血管造影检查为富血供的肿瘤。BACKGROUND & OBJECTIVE: It is difficult to differentiate intracranial hemangiopericytomas(HPC) and meningioma because of their similar imaging features. This study was to describe the features of computer tomography(CT), magnetic resonance imaging(MRI), and angiography of intracranial HPC. METHODS: We retrospectively reviewed the CT, MRI and angiography findings in 9 cases of intracranial HPC confirmed surgically and pathologically(7 male and 2 female, 33-64 years old, mean 44 years). The diagnostic images included 9 plain CT scans and 4 contrast-enhanced CT scans, 7 pre- and post-Gd enhanced MRI examinations, and 2 angiography examinations. RESULTS: The tumors located at: anterior fossa(n=2), middle fossa (n=3), posterior fossa(n=3), cerebral falx(n=1). All the tumors were more than 5 cm in size(maximum 8 cm), multilobular in shape; there were broad-based attachment to the dura and surrounded by edema with mass effect. On plain CT scans, all 9 showed hyperdense with cortical, bone erosions were presented in 2 cases; none had hyperostosis or tumor calcification. On all four contrast-en- hanced CT scans showed tumor enhancement with contrast. On the seven plain MRI, all tumors were isointense with gray matter on T_1WI, and were high-intense or slight high-intense on T_2WI. All 7 tumors with contrast-enhanced T_1WI showed enhancement; five of the 7 had also have'duraltail' sign. Angiographyshowedrich- ly vascular tumor and vascular supply from branches of the internal carotid or vertebral arteries and external carotid. CONCLUSION : The authors concluded that:(1) multilobulated masses with necrosis areas but without calcification; tumor showed cystic degeneration and edema around tumor;(2) heterogeneous enhancement on both contrast-enhanced CT and MRI;(3) angiography showed richly vascular tumor were imaging features suggestive of HPC.

关 键 词：颅内血管外皮瘤 诊断 影像学特征 磁共振成像 CT检查 

分 类 号：R739.41[医药卫生—肿瘤] R730.4[医药卫生—临床医学]