DWI和SWI在颅后窝实质性血管母细胞瘤的诊断价值  

The Diagnostic Value of DWI and SWI in the Posterior Fossa Solid Hemangioblastoma

作　　者：王晓冬[1] 程敬亮[1] 孙梦恬[1] 赵珊珊[1] 宋承汝[1] 

机构地区：[1]郑州大学第一附属医院磁共振科

出　　处：《中国医学计算机成像杂志》2014年第2期116-120,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨DWI和SWI在颅后窝实质性血管母细胞瘤的诊断价值,提高对该病的诊断水平。方法:回顾性分析经手术病理证实的19例颅后窝实质性血管母细胞瘤共计27个病灶的MR表现与临床资料。结果:15例单发,位于小脑半球6个,小脑上蚓部3个,下蚓部4个,第四脑室底2个。4例多发,12个病灶,位于小脑半球8个,延髓背侧2个,第四脑室1个,上段颈髓1个。肿瘤表现为均匀或不均匀稍等、长T1及混杂长T2信号,DWI(b=1000s/mm2)为低信号,ADC图为高信号,ADC均值为1.985×10-3 mm2/s。17个病灶内部或周边见流空血管,21个病灶周围可见不同程度水肿,SWI序列3个病灶内部或周边可见回流静脉影,4个病灶周边见低信号含铁血黄素环。增强扫描所有肿瘤呈均匀或不均匀明显强化。结论:颅后窝实质性血管母细胞瘤的DWI和SWI表现具有一定特征性,DWI低信号,ADC值升高,SWI上回流静脉、周边含铁血黄素沉积环的显示有助于明确诊断,但不典型实质性血管母细胞瘤需同成人髓母细胞瘤、脑动静脉畸形、脑膜瘤等疾病鉴别。Purpose： To investigate the diagnostic value of DWI and SWI in the solid hemangioblastomas of the posterior fossa and to improve the diagnosis level of this disease. Methods： The MRI findings and clinical data of 19 cases posterior fossa solid hemangioblastomas with 27 lesions confirmed by surgery and pathology were analyzed retrospectively. Results： Fifteen cases showed single lesion. Six cases were located in cerebellar hemisphere, 3 cases in superior vermis, 4 cases in inferior vermis, 2 cases in the bottom of the fourth ventricle. Four cases were with multiple lesions, and were with 12 lesions totally. Eight lesions located in cerebellar hemisphere, 2 lesions in dorsal medulla, 1 lesion in fourth ventricle, 1 lesion in the upper cervical spinal cord. The tumors were shown with homogeneous or inhomogeneous iso-intense or slight hypo-intense signal on T1WI, mixed hyper-intense on T2WI, hypo-intense on DWI （b=1000s/mm2）, hyper-intense on ADC. Average ADC value was 1.985 × 10-3 mm2/s. Blood vessel flow-void sign could be seen within and around the masses in 17 lesions. Twenty-one lesions were shown with edema around the masses. Veins were seen around the mass on SWl in 3 lesions. Peripheral hemosiderin presented as ring- like hypo-intensity was shown on SWI in 4 lesions. Marked homogeneous or heterogeneous enhancement was seen in all cases after contrast administration. Conclusion： There are certain DWI and SWI features of posterior fossa solid hemangioblastomas, features of hypo-intense on DWI, with increased ADC value, veins and hemosiderin ring on SWI are helpful to confirm the diagnosis, but atypical lesions should be differentiated from medulloblastoma in adults, meningioma, and cerebral arteriovenous malformations.

关 键 词：颅后窝 实质性血管母细胞瘤 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]