髓母细胞瘤的MRI和MRS特征分析  

Analysis on MRI and MRS Features of Medulloblastoma

作　　者：李劲[1,2] 梁宗辉[1] 李克[2] 褚梅花[1] 赵华丽[1] 

机构地区：[1]上海市静安区中心医院(复旦大学附属华山医院静安分院)放射科 [2]复旦大学附属华山医院放射科

出　　处：《中国医学计算机成像杂志》2014年第3期222-226,共5页Chinese Computed Medical Imaging

摘　　要：目的:通过分析髓母细胞瘤的MRI表现,提高对髓母细胞瘤的认识。方法:回顾性分析33例经手术病理证实的髓母细胞瘤,对肿瘤发生部位、MRI信号、增强后强化、囊变、出血以及MRS等表现进行分析。结果:33例髓母细胞瘤中22例位于第四脑室小脑蚓部区,9例位于半球;其中T1WI呈低信号或略低信号29例,等低混杂信号3例;T2WI呈略高信号或不均匀略高信号24例,高信号5例;DWI高信号32例;增强扫描轻度或中度云絮状强化17例,明显强化11例;病灶内微囊变20例,中囊变6例;19例见瘤周囊变。以10岁或20岁为界分组,χ2分析发生于中线和小脑半球无统计学差异(P>0.05)。5例行1H-MRS检查,实性部分Cho峰明显升高,NAA峰降低,Cho/Cr及Cho/NAA明显升高,Lac峰轻度升高。结论:髓母细胞瘤在MRI具有一定的影像学特征,结合MR多功能成像技术,有助于提高诊断正确率。Purpose：To investigate the MR findings and MR spectroscopy feature of medulloblastoma.Methods：Thirty-three cases of medulloblastoma confirmed by histopathology were analyzed retrospectively on location,signal intensity,enhancement pattern,cysts,bleed and MR spectroscopy.Results：Of 33 medulloblastomas,22 located in the four ventricle cerebellar vermis,9 located in the hemisphere.Twenty-nine cases were shown with hypo-intense signal,and 3 cases were shown with hypointense or iso-intense on.Twenty-four cases were shown with slightly hyper-intense or heterogeneous hyper-intense signal,and 5 cases were shown with hyper-intense signal on T2WI.Thirty-two cases were with hyper-intense signal on DWI.The solid components with subtle or medium enhancement in 17 cases,and marked enhancement in 11.Twenty cases were with intra-lesion micro-cysts,and 6 with mid-cysts.Peri-lesion cysts were shown in 19 cases.There was no significant difference between the occurrence of tumor located in the midline and in the cerebellum in patients younger than 10 or 20 and older than 10 or 20 （P＞0.05）.Spectral maps of 5 cases showed high choline and Lac peak,low NAA peak,and a significantly high Cho/Cr and Cho/NAA ratio.Conclusion：Medulloblastoma has some characteristic features of MRI and MRS,from which preoperative diagnosis will benefit.

关 键 词：髓母细胞瘤 磁共振成像 磁共振波谱成像 

分 类 号：R739.4[医药卫生—肿瘤]