颅内表皮样囊肿的影像学诊断  

Imaging diagnosis of intracranial epidermoid cysts

作　　者：宋爱芹[1] 李文武[1] 李万湖[1] 陈兆秋[1] 候栋梁[1] 

机构地区：[1]山东省肿瘤医院CT室,山东济南250117

出　　处：《中华肿瘤防治杂志》2006年第8期621-623,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:分析颅内表皮样囊肿的CT和MRI表现。方法:对30例经手术及病理确诊的颅内表皮样囊肿的CT和MRI表现作回顾性分析,其中30例作MRI平扫与增强扫描;20例作CT平扫检查。结果:肿瘤位于桥前池及桥小脑角池18例,4例位于鞍上,2例位于鞍旁,5例位于第四脑室,1例位于小脑延髓池。肿瘤大小不等,形态不规则,轮廓光整或呈分叶状。CT平扫17例呈均匀低密度,2例呈稍不均匀低密度,CT值为-15～10Hu,1例呈高密度。MRI平扫28例T1加权像上肿瘤呈不均的低信号,T2加权像上呈不均匀高信号,部分病例在FLAIR图象上表现为不均匀高信号,与周围低信号的脑脊液分界清晰;2例表现为T1加权像上为高信号,T2加权像上为低信号。增强后,2例肿瘤边缘有轻微强化,其余肿瘤均无明显强化。结论:典型的颅内表皮样囊肿,通过CT和MRI检查可做出准确诊断,并可以与颅内其他疾病相鉴别;在鉴别诊断中,MRI优于CT。非典型的颅内高密度囊肿,必须CT和MRI相结合诊断,为准确的术前诊断提供更多的信息。OBJECTIVE： To analyze the features of intracranial epidermoid cysts on CT and MR imagings. METHODS.. Thirty patients with intracranial epidermoid cysts proven surgically and pathologically were examined with pre- and post-contrast enhanced MR imaging, and 20 of 30 patients also undergone CT plain scan. CT and MR imagings of 30 cases were retrospectivelly reviewed. RESULTS.. Among thirty cases, 18 were located in the cisterns of cerebell opontine angle,4 in the suprasellar, 2 in the parasellar region, 5 in the fourth ventricles and 1 in the cerebellomedullar cistern. The tumors were different in size and had irregular shapes, the contours were lobulated or smooth. On CT, 17 bases were homogeneous hypodense, 2 slightly inhomogeneous hypodense from --15 to 10 Hu in CT values. 1 cases was hyperdense. Twenty-eight of 30 imaging cases demonstrated inhomogeneous hypointensityimaging on T1WI, and inhomogenous hyperintensity on T2WI. Partial cases demonstrated inhomogenous hyperintensity. The border was clear between the tumors and the cerebrospinal fluid. Only 2 cases demonstrated hyperintensity on TIWI and hypointensity on T2WI. No contrast enhancement was noted except 2 cases with slightly periphery enhancement. CONCLUSION： The typical intracranial epidermoid cysts could be diagnosed accurately and differentiated from other similar cystic lesions with CT and MR imagings. MRI is superior to CT in differential diagnosis. Untypical intracranial epidermoid cysts should be diagnosed correlating CT with MRI, providing more data before operation.

关 键 词：表皮样囊肿 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]