椎管黏液乳头型室管膜瘤的MR表现与病理对照  

MR Imaging Manifestations of Myxopapillary Ependymoma in Spinal Canal: Comparison with Pathologic Findings

作　　者：李建瑞[1] 陈随[1] 程晓青[1] 钟健[1] 赵艳娥[1] 崔文静[1] 黄伟[1] 

机构地区：[1]南京军区南京总医院医学影像科,江苏南京210002

出　　处：《临床放射学杂志》2014年第5期667-670,共4页Journal of Clinical Radiology

摘　　要：目的探讨椎管内黏液乳头型室管膜瘤(MPE)的MRI表现与病理相关性。方法回顾性分析经手术证实的12例椎管内MPE的MRI资料,MRI征象分析包括肿瘤部位、形态、大小、信号强度和增强表现。结果 12例MPE均为单发,位于脊髓圆锥区1例,位于终丝区11例;75%(9/12)位于L2水平附近。MRI平扫T1WI肿瘤呈等信号,9例瘤内见斑片状高信号;T2WI呈高信号11例,等信号1例,10例肿瘤信号不均,瘤内掺杂点条状或斑片状低信号;增强后全部肿瘤呈显著不均匀强化,瘤内对应的T1WI高信号或T2WI低信号部分均无强化。术中所见及病理学显示肿瘤血供丰富,易出血,瘤细胞呈乳头放射状排列在血管黏液样间质轴心周围,大量黏液素积聚在血管内或环绕血管的细胞之间。结论椎管内MPE的MRI特征性表现为瘤体内T1WI等信号夹杂高信号,强化不均匀,与病理学特性密切相关。Objective To investigate MRI findings of myxopapillary ependymomas （MPE） in spinal canal and to compare these findings with pathologic results. Methods MR findings in 12 patients with surgically-confirmed MPE in spinal canal were retrospectively analyzed. MRI signs included tumor location, shape, size, signal intensity and internal enhancement. The results were analyzed. Results The lesion of MPE was single in all the 12 patients. The lesions were located at the conus medullaris region （n =1） or at the filum terminale area （n = 11）. 75% of lesions （9/12） were situated around L2 level. Plain MRI scanning demonstrated that the lesions showed iso-signal on T1WI and patch high-signal within the tumor could be seen in 9 patients, while on T2 WI high-signal was seen in 11 patients and iso-signal in one patient, and heterogeneous signal intensity with flagpole-like or patch low-signal could be detected in 10 lesions. Contrast-enhanced MRI scanning revealed that all the lesions had heterogeneous enhancement, and these areas that were characterized by high-signal on T1WI or low-signal on T2WI showed no enhancement at all. Pathologically, the tumor was rich in blood supply and easily bled. The tumor cells arranged around vascular myxoid stromal cores in a papillary radial pattern, and abundant myxoid was collected in the vessels or around the vascular cells. Conclusion The characteristic MRI manifestations of myxopapillary ependymomas in spinal canal are iso-signal mixed with high-signal within the tumor on T1WI and heterogeneous enhancement on enhanced scans. These MRI manifestations are strongly consistent with the pathologic findings.

关 键 词：黏液乳头型室管膜瘤 磁共振成像 病理 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]