机构地区:[1]南方医科大学珠江医院影像诊断科,广州510282 [2]南方医科大学珠江医院神经外科,广州510282 [3]南方医科大学珠江医院消化内科,广州510282
出 处:《中华神经医学杂志》2007年第8期825-828,共4页Chinese Journal of Neuromedicine
摘 要:目的评价MRI对鞍上肿瘤的诊断价值。方法回顾性分析我院23例鞍上肿瘤患者临床及头颅MRI资料,其中颅咽管瘤8例,脑膜瘤5例,室管膜瘤和生殖细胞瘤各3例,毛细胞星形细胞瘤和表皮样囊肿各2例。结果颅咽管瘤边界光整,肿瘤以囊性或囊性成分为主;囊性部分呈短T1、长T2信号5例,长T1、长T2信号2例,等T1、长T2信号1例;增强扫描肿瘤实质部分显著强化。5例脑膜瘤4例起源于鞍结节,1例起源于前床突,肿瘤边界光整;平扫呈等T1、稍长T2信号;增强后均匀显著强化,可见"脑膜尾征"。室管膜瘤形态极不规则,2例侵犯额叶,1例侵犯丘脑;肿瘤呈长T1、长T2信号;1例见有团块状钙化(T2WI呈低信号);增强扫描显著强化。生殖细胞瘤形态较规则,肿瘤沿垂体柄向鞍内生长,致垂体柄增粗,T1WI垂体后叶高信号消失;1例表现颅内多发病灶:2例平扫呈长T1、稍长T2信号,1例呈长T1、长T2信号,瘤内有较多数量小圆形囊变区;增强扫描肿瘤强化明显。2例毛细胞星形细胞瘤呈浅分叶状,肿瘤沿视路生长,1例肿瘤跨越前、中、后颅窝,1例显示一侧视神经增粗;平扫肿瘤呈长T1、长T2信号,边缘见有多个新月状囊变区;增强扫描肿瘤显著强化。2例表皮样囊肿形态不规则,肿瘤向后蔓延生长至环池和桥前池;呈长T1、长T2信号,内见线样间隔;增强后无强化。结论不同类型鞍上肿瘤MRI表现不同,MRI对鞍上肿瘤诊断具有重要价值。Objective To evaluate the diagnostic value of MRI on suprasellar tumors. Methods Clinical and cerebral MRI data of 23 cases with suprasellar tumors were retrospectively analyzed, including 8 cases of craniopharyngiomas, 5 cases of meningiomas, a respective 3 cases of ependymomas and germinomas and a respective 2 cases of pilocytic astrocytomas and epidermoid cysts. Results The craniopharyngiomas were cystic or mainly cystic with sharp contours; the cystic components in 5 cases were hypointense on T1-weighted images (T1WI) and hyperintense on T2-weighted images (T2WI), in 2 cases hyperintense on T1WI and T2WI, and in 1 case isointense on T1WI and hyperintense on T2WI; the tumor parenchyma was remarkably intensified after contrast-enhanced MRI scan. Four of the 5 cases with meningiomas originated from the tuberculum sellae and the other one, from anterior clinoid process; all the tumors presented sharp contours, isointense on T1WI and slightly hyperintense on T2WI, and were demonstrated to be remarkably intensified after contrast-enhanced scan, when "dural tail sign" could also be observed. Among the irregular 3 cases of ependymomas, 2 cases involved the frontal lobe and 1 case involved the thalamus; all tumors were hyperintense on T1WI and T2WI, among which 1 was detected to have massive calcification (low signal intensity on T2WI); tumors were intensified after the administration of contrast-enhanced scan. All the germinomas were regular in morphology, which grew along the pituitary stalk into the sellae and until the pituitary stalk was thickened, the high signal intensity of the posterior lobe of pituitary gland vanished from TIWI; multiple intracranial lesions were detected in 1 case; 2 of the 3 cases ofgerminomas given plain scan were hyperintense on T1WI and slightly hyperintense on T2WI, and 1 case, hyperintense on T1WI and T2WI, with a comparatively large number of small round area of cystic changes inside; all tumors showed apparent intensification aRer contrast-enhanced scan. The 2 cases
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