颅内浆细胞肉芽肿MRI表现及4例误诊分析  

The MRI Misdiagnosis Analysis of Intracranial Plasma Cell Granuloma(4 Cases Report and Literature Review)

作　　者：陈东[1] 刘莉丽[1] 邱丽华[2] 韩福刚[1] 孙贞超[1] 郭召友[1] 

机构地区：[1]泸州医学院附属医院放射科MR室,646000 [2]四川宜宾市第二人民医院放射科,644000

出　　处：《临床放射学杂志》2009年第3期425-427,共3页Journal of Clinical Radiology

摘　　要：目的探讨中枢神经系统浆细胞肉芽肿(PCG)的MRI表现及误诊原因。资料与方法对经手术病理证实的4例颅内PCG的临床资料及MRI表现进行回顾性分析。结果4例病灶分别位于右侧额顶叶、右侧桥小脑角区、右侧中颅窝蝶鞍旁及左侧上矢状窦旁,T1WI、T2WI多表现为等或稍高信号,合并出血时可均呈高信号,扩散加权成像多呈等低信号,液体衰减反转恢复序列(FLAIR)可呈等、低或高信号,增强后多呈明显均匀强化。其中1例位于脑内,术前误诊为转移瘤或胶质瘤伴出血。3例位于脑外,其中2例可见脑膜尾征,术前误诊为脑膜瘤。结论颅内PCG少见,MRI无特征性表现,确诊有赖于病理检查,免疫组织化学检查有助于鉴别诊断。Objective To explore the imaging manifestations and to analyze the reasons of misdiagnosis of Intracranial Plasma Cell Granuloma. Materials and Methods The clinical data and MRI manifestations of 4 eases with intracranial plasma cell granuloma confirmed by pathology were collected. Results Four cases were located in right cerebellopontine angle, fight frontoparietal lobe, right middle cranial fossa and left parasaggital sinus. The lesions often showed isointensity or slight hyperintensity on T1 weighted imaging（ T1WI） and T： weighted imaging（ T2WI）. or hyperintensity When bleeding occurred . The lesions showed iso-hypointensity and hyper-iso-hypointensity on Diffusion weighted imaging（DWI） and fluid attenuated inversion recovery（FLAIR）. After injected Gadolinium, lesions showed homogenous enhancement . One lesion located intraencephalon was misdiagnosed as metastasis tumor or glioma, before operation Three lesions located extraenceph- alon were misdiagnosed as meningioma because 2 cases showed meningeal tail sign. Conclusion Intracranial plasma cell granuloma is rare and prone to be misdiagnosed. The final diagnosis depend on pathology and i mmunohistochemistry.

关 键 词：中枢神经系统 浆细胞肉芽肿 磁共振成像 误诊分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]