中枢神经系统黑色素细胞肿瘤的影像诊断（附17例报告）  

Radiologic diagnosis of melanocytic neoplasms in central nervous system ：report of 17 cases

作　　者：肖翔[1] 许乙凯[1] 林洁[2] 代月黎[1] 陈婉琪[1] 李维粤[1] 吴元魁[1] 

机构地区：[1]南方医科大学南方医院影像诊断科,广东广州510515 [2]南方医科大学南方医院病理科,广东广州510515

出　　处：《实用放射学杂志》2013年第9期1403-1406,1433,共5页Journal of Practical Radiology

摘　　要：目的 分析总结中枢神经系统（CNS）黑色素细胞肿瘤的CT和MRI影像特征.方法 回顾性分析17例经手术病理证实的CNS黑色素细胞肿瘤患者的临床和CT、MRI资料.13例行MRI平扫和增强,其中1例另行CT平扫,1例另行CT平扫和增强;3例仅行CT平扫;1例行CT平扫和增强.结果 （1）肿瘤类型、数量及分布：原发性黑色素瘤6例,幕上5例,幕下1例,共6个原发灶,2例出现颅骨、颅外转移;转移性黑色素瘤9例,单发2例,多发7例,共60个病灶,幕上52个;黑色素细胞瘤2例,幕上单发者1例,椎管内多发（3个）1例.（2）边界和瘤周水肿：50个瘤灶边界清晰,占71.4%;40个未见明显水肿,轻度水肿15个.（3）密度和信号特点：CT检出病灶15个,等密度8个,高密度6个.MRI检出病灶57个,黑色素型8个,无黑色素型25个,中间型18个,血肿型6个.（4）强化模式：均匀明显强化32个,环状强化15个,不均匀弥漫性强化8个.结论 CNS黑色素细胞肿瘤具有一定的影像特征,尤其是黑色素型肿瘤,综合分析临床和影像资料有助于提高术前诊断的准确性.Objective To characterize the CT and MRI manifestations of melanocytic neoplasms in central nervous system. Methods CT and MRI manifestations and clinical data of 17 cases with melanocytic neoplasms proved by histological results were reviewed. Thirteen patients underwent non-contrast and contrast MR scan, among which one patient with CT plain scan and another with both plain and contrast CT scan. Other three patients performed CT plain scan only and tile last one performed both plain and contrast CT scan. Results （]）The types, quantity and distribution of tumors： 6 primary melanomas in 6 patients were found with 5 lesions at supratentorial region and one at infratentorial region, and with extracranial or skull bone metastasis in 2 patients; 60 lesions in 9 patients with metastatic melanomas （2 patients with single lesion and 7 with multiple lesions} were found,including 52 le- sions at supratentorial region; 2 patients with meningeal melanocytomas were found including one patient with a single lesion and an- other with multiple ones. （~）The borders and perifocal edema of tumors： there were 50 lesions with well-defined border, 40 without edema and 15 with mild edema. QDensity and signal intensity： there were 15 lesions detected on C＇F images with iso density in 8 le- sions and hyperdensity in 6, and 57 leseions detected on MRI images with melanotic type in 8 lesions, amelanotic type in 25, inter- mediate type in 18 and hematoma type in 6. （~）Enhanced pattern：homogeneously remarkable enhancement was seen in 32 lesions, rim-shaped enhancement in 15 and non homogeneous and diffuse enhancement in 8. Conclusion Melanocytic neoplasms in central nervous system have some imaging characteristics, especially for the melanocytic melanoma. Comprehensive analyzation of the elini cal data and imaging findings may help to improve the diagnostic accuracy.

关 键 词：中枢神经系统 黑色素肿瘤 计算机体层成像 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R814.42[医药卫生—临床医学]