脑实质内室管膜瘤的MR诊断与鉴别诊断  

MR diagnosis and differential diagnosis of intraparenchymal ependymoma

作　　者：刘彩霞[1] 陈燕萍[1] 唐姗姗[1] 吴芹[1] 徐嬿[1] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《医学影像学杂志》2011年第7期940-942,共3页Journal of Medical Imaging

摘　　要：目的:分析脑实质内室管膜瘤的MRI表现,旨在提高对其诊断的准确率。方法:对经手术病理证实的12例脑实质内室管膜瘤进行回顾性分析,均行颅脑MR平扫及增强扫描检查。结果:肿瘤10例位于幕上,其中5例位于丘脑,2例位于额叶(其中1例通过胼胝体累及双侧额叶),1例位于颞叶,1例位于额颞叶,1例位于颞枕交界区;幕下脑实质内室管膜瘤2例,1例位于小脑半球,1例位于小脑蚓部。10例肿瘤与脑室关系密切。7例肿瘤表现为实质型,T1WI呈低信号,T2WI呈高信号,其中2例病灶内有出血灶,4例可见多发小液化囊变区;5例表现为囊实性型,囊性部分T1WI呈低信号,T2WI呈明亮的高信号,信号与脑脊液信号相似,T2FLAIR像上呈低信号;实性部分T1WI呈等或略低信号,T2WI呈略高信号。增强扫描瘤体呈明显不均匀强化。结论:脑实质内室管膜瘤多发生于幕上,且多见于侧脑室三角区周围,与脑室关系密切,多呈实性,周围水肿多不明显。MRI表现有一定的特点,但多数情况下术前明确诊断困难。Objective：To analyse the MRI features of intraparenchymal ependymoma and to improve the dianostic acuracy of it. Methods： The pre-and post-contrast MR images of 12 cases with intraparencbymal ependymoma confirmed by surgery and pathology were analyzed retrospectively. Results：Among all the 12 cases, 10 lesions located at the supratentorial cerebrum, 5 of which located at thalamus, 2 frontal lobe （1 of which involved bifrontal lobes through eallosum）, 1 temporal lobe, 1 frontotemporal lobe and 1 involved the junctional zone between parietal lobe and occipital lobe. Other 2 lesions located in posterior fossa ependymorna, including; cerebellum （1 case） and vermis （1 case）. Among them, 10 cases were closed to ventricle. Seven cases of intraparenchymal ependymoma were solid, appearing hypo-intense singals on T1-weighted image and hyper-intense singals on T2-weighted image, in which a blood area was reveled in 2 case and many liquified cystic areas in 4 cases. Five cases were partial cystic type. The cyst fluid was CSF-like with low intensity on T1-weighted image, bright high intensity on T2-weighted image and low intensity on T2 FLAIR; The parenchyma of the tumors presented iso-intense or hypo-intense singals on T1-weighted image and hyper-intense singals on T2-weighted image. After adiministration of contrast medium, the tumors demonstrated hyperdense with marked inhomogeneous enhancement. Conclusion：Intraparenehymal ependymoma frequently located at supratentorial cerebrum, usually located at the trigone of lateral ventricle, most appearing solide with slighted peritumoral edema. Although the MR findings are somehow characteristic, it is difficult to get definate diagnosis before operation.

关 键 词：脑实质 室管膜瘤 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]