脑室外神经细胞瘤的临床病理和影像表现  

Ciinicopathological and neuroradiological study of extraventricular neurocytoma

作　　者：代月黎[1] 许乙凯[1] 粱文[3] 赵亮[2] 陈婉琪[1] 李维粤[1] 肖翔[1] 严承功[1] 吴元魁[1] 

机构地区：[1]南方医科大学南方医院影像中心,广州510515 [2]南方医科大学南方医院病理科,广州510515 [3]南方医科大学珠江医院放射科

出　　处：《中华放射学杂志》2013年第5期414-420,共7页Chinese Journal of Radiology

摘　　要：目的结合文献探讨脑室外神经细胞瘤（EVN）的临床病理、影像表现特点和鉴别诊断。方法回顾性分析临床资料完整并经病理证实的EVN患者9例。所有患者均行MR平扫和增强扫描，其中6例患者行液体衰减反转恢复（FLAIR）序列扫描。2例患者行CT平扫和增强扫描。同时，检索联机医学文献分析和检索系统（Ovid Medline）、美国国家医学图书馆检索系统（PubMed）、荷兰医学文摘数据库（Embase）和中国生物文献数据库1980年1月至2012年8月收录的相关文献，综合分析EVN的临床病理表现及影像特点。结果该研究共9例患者，男5例，女4例，年龄2～59岁。3例病灶位于大脑半球，3例位于中脑，松果体、小脑蚓部和鞍区各1例。2例患者CT平扫病灶呈等或稍高密度。9例患者MR检查肿瘤T1WI呈低或等信号，T1WI呈高信号，增强扫描8例呈不均匀强化，程度不一，1例无强化。6例FLAIR序列呈高信号。出血3例，完全实性2例，完全囊性1例，囊变6例，钙化2例。7例肿瘤边界清晰，2例模糊。4例无瘤周水肿，3例轻度水肿，中度和重度水肿各1例。文献报道EVN共142例，男78例，女63例，中位年龄31岁（其中1例未提供性别和年龄）。86例位于大脑半球，其中额叶38例，位于脊髓23例，中枢神经系统以外12例。CT平扫肿瘤呈低、等或稍高密度，MR T1WI呈稍低或等信号，T2WI为稍高或明亮高信号，增强扫描多数肿瘤可见不均匀强化，程度不一。瘤周多无或轻度水肿，钙化、出血及血管流空影少见。结论EVN罕见，男性多见，好发于额叶。对于境界清楚，累及皮层或同时累及白质，具有囊变，无或轻度瘤周水肿的脑实质肿瘤，应把EVN列入鉴别诊断。Objective To analyze clinicopathologic features, imaging findings, and differential diagnosis of extraventricular neurocytomas （EVN） after the literature were comprehensively reviewed. Methods Nine cases with pathologically proved EVN were analyzed retrospectively. Plain and post-contrast MRI were performed in all 9 patients, of which 6 patients underwent a liquid attenuation inversion recovery （FLAIR） sequence scanning. Plain and enhanced CT were performed in 2 cases. Meanwhile, Clinical manifestations and imaging features of the reported EYN cases in literature were reviewed comprehensively by searching Ovid Medline, PubMed, Embase and China biological literature database. Results Among the 9 patients,5 were nmle and 4 were female with age range from 2 to 59 years. The lesions located in cerebral hemispheres in 3 cases,in midbrain in 3 cases and in the pineal gland,vermis and sellar region in 1 case respectively. Two cases with CT data appeared iso-dense or slightly hyperdense. On MRI,all 9 lesions presented hypointense or isointense on T1WI, hyperintense on T2WI and mild to marked heterogeneous enhancement except one with no enhancement. Six cases showed hyperintense on FLAIR sequence. Other images signs included bleeding in 3 patients, completely solid components in 2 cases,completely cystic in 1 case, cystic change in 6 cases and calcification in 2 cases. Seven tumors showed clear border. Peritumoral edema was found in 5 cases with mild in 3 cases, moderate and severe edema in 1 case respectively. Four cases showed no edema. In the reported 142 cases with EVN ,78 cases were male and 63 were female,with an median age of 31 years（ one of the patients did not provide theinformation of gender and age ） . The tumor in 86 cases were located in cerebral hemispheres, of which 38 cases were in frontal lobe,23 cases in spinal c, ords,and 12 cases outside the central nervous system. CT scans appeared low density,iso-dense or slightly hyperdense. MRI scans presented hypointense or isointense on T1WI, hyperin

关 键 词：神经细胞瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R44[医药卫生—诊断学] R73[医药卫生—临床医学]