“半月征”和“垂直征”在中枢神经肿瘤样脱髓鞘病磁共振诊断中价值探讨  

The value of open-ring sign and vertical sign in MRI diagnosis of tumor-like masses of demyelination of central nervous system

作　　者：廖波[1] 韩福刚[1] 何晓鹏[1] 舒健[1] 屈春晖[1] 刘年元[1] 

机构地区：[1]泸州医学院附属医院放射科,四川泸州646000

出　　处：《泸州医学院学报》2012年第2期165-168,共4页Journal of Luzhou Medical College

摘　　要：目的:描述中枢神经肿瘤样脱髓鞘病的MRI表现,探讨该病变的MRI诊断价值。方法:对进行了MRI检查的5例经手术及活检证实为肿瘤样脱髓鞘病的MRI影像学表现特征进行回顾性分析。结果:MRI显示4例表现为单发局限性肿块;1例表现为多发肿块。3例呈均匀长T1信号,2例呈短T1与长T1混杂信号;3例呈均匀长T2信号,2例呈不均匀长T2信号;3例MRI:冠状位、矢状位显示"垂直征"或病灶的部分有"垂直征"倾向。全部5例经钆喷酸葡胺注射液(Gd-DTPA)增强,单发病灶者呈不均匀强化,边缘呈非闭合性环形增强("半月征"),靠近脑室侧强化较靠近灰质侧明显;多发病灶者无明显强化。结论:中枢神经肿瘤样脱髓鞘病影像学诊断较困难,MRI检查常将本病误诊为肿瘤。认识其MRI表现特点有助于诊断该疾病,以避免手术造成的严重损伤,但最终确诊仍需脑病变组织活检。Objective： To study the MRI features of tumor like masses of demyelination of the central nervous system and to discuss their diagnostic value.Methods： Five patients with biopsy-proven tumor like masses of demyelination underwent MRI were reviewed.The findings of MR imaging were retrospectively analyzed and the clinical symptoms were also analyzed.Results：MR imaging demonstrated solitary mass in 4 cases,and multiple mass in 1 case.On T1WI,the lesions presented homogeneous low signal in 3 cases,and mixed high and low signal in 2 cases.On T2WI,the lesions presented homogeneous high signal in 3 cases,and mixed high and low signal in 2 cases;Three cases of MRI displayed＂vertical sign＂ in coronal and sagittal position,or some lesions had ＂vertical sign＂tendencies.All 5 patients were enhanced with Gd-DTPA injection.The case with single lesion showed heterogeneous enhancement of non-closed ring edges（＂open-ring sign＂）.The enbancement was more obvious closer to the ventricular side than to the gray matter the cuse with;multiple lesions were not significantly enhanced.Conclusion：It is a difficult task to make correct diagnosis of the tumor like masses of demyelination,and this disease is often misdiagnosed as tumor by MRI.The comprehensive understanding of the MRI features would be helpful in diagnosing the tumor like masses of demyelination,thus avoiding the devastating injury caused by surgery.The definite diagnosis relies on brain biopsy.

关 键 词：肿瘤样脱髓鞘病变 中枢神经 磁共振成像 半月征 垂直征 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学]