MRI在鞍区毛细胞型星形细胞瘤和颅咽管瘤鉴别诊断中的应用  

Application value of MRI in distinguishing sellar pilocytic astrocytoma from craniopharyngioma

作　　者：唐兴[1] 印弘[1] 张斌 康晓伟[1] 张静静[2] 刘先平[1] 魏光全[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]西安工程大学理学院应用数学专业

出　　处：《实用放射学杂志》2014年第3期390-393,398,共5页Journal of Practical Radiology

摘　　要：目的 探讨鞍区毛细胞型星形细胞瘤（pilocytic astrocytoma，PA）及颅咽管瘤的CT和MR影像表现特点, 提高鞍区PA的诊断准确性。方法 回顾性分析9例鞍区PA及21例颅咽管瘤的MRI与CT表现、病理及临床资料；影像学特点包括病灶部位、大小、钙化、出血、脑积水、构成成分及信号特征。结果 鞍区PA含实性成分者占8/9，颅咽管瘤含囊性成分者占18/21，二者中位体积分别为78 cm3、27.5 cm3，钙化发生率分别1/4、16/19（P＜0.05），脑积水发生率分别为1/8、9/21（P＜0.05）；临床症状无特异性。增强扫描PA囊壁多呈不规则强化，而颅咽管瘤囊壁多规整，囊液信号多样。结论 2组肿瘤的发病年龄、大小、钙化及脑积水发生率、囊性成分信号特点、囊壁强化方式等对二者的鉴别诊断有一定的提示作用。Objective To explore the characteristics of MRI manifestations of pilocytic astrocytoma and craniopharyngioma in sellar region, and to improve the diagnostic knowledge o{ sellar pilocytic astrocytoma. Methods The MRI and CT findings,patholo- gies and clinical data of sellar pilocytic astrocytoma （9 cases） and craniopharyngioma { 21 cases） were analyzed retrospectively. Le- sion imaging features included position, size, presence of calcification, hemorrhage, hydrocephalus,composition and signal charac- teristics. Results Solid component was dominant in eight PAs （8/9） ,and cystic component was dominant in eighteen craniopharyn- giomas （ 18/21 ） , and the median volume were 78 cm3 and 27.5 cm3 , respectively. The calcification was noted in 1 PA （ 1/4 ） and in 16 craniopharyngiomas （16/19）. The hydrocephalus was noted in 8 PAs （8/9） and in 9 craniopharyngiomas （ 9/21 ） （ P〈 0.05 ）. Clinical symptoms were not significantly different. The majority of the PA showed irregularly ring enhanced wall, while most cra- niopharyngiomas demonstrated regular cystic wall and various intensity of the cystic component. Conclusion The peak age for the onset of symptoms,size, presence of calcification and hydrocephalus , signal characteristics and enhancement pattern of cystic compo nent are helpful characteristics to distinguish these two types of tumors.

关 键 词：鞍区 毛细胞型星形细胞瘤 颅咽管瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]