颅内间变型血管外皮细胞瘤的影像与病理对照  

Comparison of Imaging and Pathological Findings of Intracranial Anaplastic Hemangiopericytoma

作　　者：张婧 周俊林[2] 董驰[2] 

机构地区：[1]兰州石化总医院影像科甘肃兰州730060 [2]兰州大学第二医院放射科甘肃兰州730030

出　　处：《中国医学影像学杂志》2012年第10期721-724,共4页Chinese Journal of Medical Imaging

基　　金：甘肃省兰州市科技计划资助项目(其他)(07-1-84)

摘　　要：目的探讨颅内间变型血管外皮细胞瘤的影像学特征及病理表现。资料与方法回顾性分析经手术病理证实的21例颅内间变型血管外皮细胞瘤的影像学及病理资料,其中15例患者接受CT平扫及增强扫描,21例患者均接受MR平扫及增强扫描。结果 21例患者中,所有病灶位于颅内脑外,位于颅底11例。病灶呈分叶状或不规则形20例,跨叶生长9例。CT平扫呈等、稍高、低混杂密度14例,等密度1例,颅骨破坏10例,瘤内钙化1例;增强扫描呈不均匀显著强化14例。MR平扫T1WI呈等、高、低混杂信号20例,等信号1例;T2WI呈高、低混杂信号18例,等、低混杂信号2例,等信号1例;增强扫描呈不均匀显著强化19例,明显坏死囊变16例,明显出血7例,以窄基底与脑膜相连15例,颅骨破坏12例,瘤周水肿明显16例。手术见肿瘤呈分叶状或不规则形20例,以窄基底与硬脑膜相连15例。镜检示肿瘤坏死囊变20例,出血9例,瘤细胞弥漫分布,间质有大量裂隙状血管,免疫组化显示Ki-67表达升高。结论颅内间变型血管外皮细胞瘤外形具有更明显的分叶状,血供丰富,肿瘤易出血、坏死、囊变致密度或信号不均匀,增强效应显著,多以窄基底与硬膜相连,相邻颅骨溶骨性破坏,占位效应及瘤周水肿明显。Purpose To compare CT,MR imaging features with pathological findings of intracranial anaplastic hemangiopericytoma.Materials and Methods Twenty-one cases of pathology proven intracranial anaplastic haemangiopericytoma were analyzed retrospectively.15 cases underwent CT plain and contrast enhanced scans.21 cases underwent plain and contrast enhanced MR scans.The imaging findings were analyzed and correlated with pathology.Results All the intracranial tumors of 21 patients were located outside the brain parenchyma.11 tumors were located in the skull base.20 tumors were lobulated with 9 involving more than one lobe.On CT,the lesions were manifested as heterogeneous（n=14） or isodense（n=1）.10 cases showed bony destruction.1 case had calcification.After contrast injection,uniform enhancement was seen in 14 cases.On MRI,the lesions showed heterogeneity（n=20） or isointensity（n=1） on T1WI,mixed high-low signal（n=18） or iso-low signal（n=2） or iso-signal（n=1） on T2WI.After contrast injection,uniform enhancement was seen in 19 cases.Significant necrosis and cystic changes were seen in 16 cases and hemorrhage in 7 cases.15 tumors had narrow-based dural attachment.12 cases demonstrated bony destruction.16 cases showed significant peritumoral edema.During surgery 20 tumors were lobulated or irregular in shape with narrowbased dural attachment in 15.Pathology showed necrosis and cystic changes in 20 cases,hemorrhage in 9 cases.Tumor cells were diffusely distributed.The stromal had large number of slit-like vasculature.Immunohistochemistry showed high Ki-67 expression.Conclusion CT and MRI can show characteristic findings in intracranial anaplastic hemangiopericytoma and help with diagnosis.

关 键 词：血管外皮细胞瘤 脑肿瘤 体层摄影术 X线计算机 磁共振成像 病理学 外科 

分 类 号：R739.41[医药卫生—肿瘤] R730.42[医药卫生—临床医学]