颅内占位性病变CT、MRI误诊教训及对策  

Misdiagnostic Analysis and Strategies of CT and MRI for Intracranial Mass Lesions

作　　者：张振峰[1] 张承惠[2] 吴沛宏[1] 张伟章[1] 阮超美[1] 郑列[1] 李家尧[1] 伍尧泮[1] 蔡培强[1] 

机构地区：[1]中山医科大学肿瘤防治中心影像介入科,广东广州510060 [2]孙逸仙纪念医院

出　　处：《中国医学影像技术》2001年第10期948-950,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　分析影像学误诊的颅内占位性病变CT、MRI表现 ,总结其误诊原因及经验教训。方法　手术 (活检 )病理或临床确诊的CT、MRI曾误诊的颅内占位性病变 61例 ,回顾性分析其征象表现并归纳出五类主要误诊原因。结果　CT、MRI总误诊率为 1 2 .2 %。①部位误导者 49例次 ;②“典型”征误导者 9例次 ;③征象不典型致误者 3 2例次 ;④少见病致误者 2 4例次 ;⑤思维片面致误者 2 5例次。结论　从两个方面降低误诊率 :①认真琢磨基本功 ,不断积累病例诊断正反两方面经验 ,提高发现病变和分析鉴别诊断的能力 ;②影像观察分析要密切结合临床资料 ,注意形态与功能的联系。Objective To analyze the features of CT and MR imaging of intracranial mass lesion which have been misdiagnosed, and to summarize the causes of misdiagnosis and strategies. Methods 61 cases of intracranial masses proved by pathology and clinic have been misdiagnosed by CT and MRI. The imaging characteristics of the cases have been retrospectively investigated and five kinds of misdiagnostic reasons have been mainly concluded. Results The total misdiagnostic rate of CT and MRI is 12.2%. ①49 times misdiagnosis are induced by localization; ②9 times misdiagnosis are induced by 'typical signs'; ③32 times of misdiagnosis are caused by atypical signs; ④24 times misdiagnosis are due to rare diseases; ⑤25 times misdiagnostic reasons are one sided thinking. Conclusion It is necessary to reduce imaging misdiagnostic rate:①To accumulate basic diagnostic experiences step by step, and to promote abilities of detecting and differentiating abnormal signs; ②Must combine closely image observation and analysis with clinical data, and must pay much attention to relationships between morphology and function.

关 键 词：颅内肿瘤性病变 磁共振成像 误诊 CT 诊断 

分 类 号：R739.410.4[医药卫生—肿瘤]