幕上原始神经外胚层肿瘤的MRI表现及病理基础  

Supratentorial primitive neuroectodermal tumor：MRl features and pathological fundament

作　　者：李瑞[1] 宋英儒[2] 黄仲奎[2] 龙莉玲[2] 

机构地区：[1]广西柳州市工人医院磁共振室,广西柳州545005 [2]广西医科大学第一附属医院放射科

出　　处：《实用放射学杂志》2013年第5期712-715,共4页Journal of Practical Radiology

摘　　要：目的探讨幕上原始神经外胚层肿瘤（SPNET）的MRI表现及病弹学基础，旨在提高对该病的影像学认识。方法回顾性分析18例经病理证实为SPNET的MRI表现，并与手术病理相对照，探讨不同病例MRI表现不相同的病理学基础。结果病灶位于额叶8例，顶叶3例，颞顶叶2例．颞叶、额顶叶、额颞叶、枕叶及侧脑室旁各1例。病灶普遍较大（3．8-9．6cm），形态不规则10例，边界清楚14例，病灶均呈囊实性肿块，信号不均匀，实质部分T1WI鼙等或稍低信号，T1W1及FLAIR呈等或稍高信号。囊变多位于周边，可见出血、流空血管影、钙化。瘤周无水肿9例．轻度水肿7例，中度水肿2例，占位效应均显著。邻近颅骨可受侵。增强后病灶明显不均匀强化16例，均匀强化1例，未见强化1例。病理组织赋乐肿瘤由低分化的排列紧密的小圆细胞构成，可向多种细胞分化，间质血管丰富；免疫表型以NSE、Vim、CD99、GFAP、Syn表达为丰。结论SPNET的MRI表现与其病理学基础密切相关．确诊仍需病理组织学及免疫组化检查。Objective To approach the MRI features and pathological fundamentals of supratentorial primitive neuroectodermal tumor（SPNET） in order 1o improve MR1 recognitions of SPNET. Methods MRI features of SPNETs confirmed by pathology in 18 cases were analyzed retrospectively,and compared to surgical features. Results The tumors located respectively in the frontal lobe（n=8 ） , parietal lobe（ n=3 ） , temporal-parietal lobes （ n = 2 ） , temporal lobe （ n=1 ） , frontal-parietal lobes （ n=1 ） , frontal-temporal lobes（n=1 ） , occipital lobe（n= 1） and lateral ventriele（n 1）. All lesions were large（3.8-9.6 cm） , irregular（10 cases） , well-de- fined（ 14 cases） soft tissue masses andinhomogeneous signal intensity with cystic areas. The solid parts of tumors showediso-orhy- po-intensity on T1WI, iso- or hyper-intensity on T2WI and FLAIR with cystic areas in periphery. Hemorrhage, flow void vessels and calcification were found inside the masses. There were no peritumoral edema in 9 eases, slight edema in 7 cases and medium ede- ma in 2 cases. The tumors displayed marked occupation effect, and adjacent bones destruction. The tumors demonstrated conspicu- ously heterogeneous contrast enhancement in 16 cases, uniforming contrast enhancement in 1 case, without contrast enhancement in 1 case. The tumors consisted of crowded undifferentiated small round ceils, with abundant of vessels, hnmunohistochemieal examina- tion showed positive NSE, Vim, CD99, GFAP and Syn in some lesions. Conclusion MRI characteristics of SPNET correlating to the pathological fundaments significantly, hut determination of SPNET still dependents on the pathological histology and immuno- histochemical method.

关 键 词：脑 神经外胚层肿瘤 磁共振成像 病理学 

分 类 号：R739.41[医药卫生—肿瘤] R446.8[医药卫生—临床医学]