颅内室管膜下瘤磁共振特征与鉴别诊断  

MRI features of intracranial subependymomas and differential diagnosis

作　　者：胡君[1] 刘文[1] 肖朝勇[1] 许云[1] 黄清玲[1] 杨荣华[1] 柴学[1] 姜辉[2] 

机构地区：[1]南京医科大学附属脑科医院放射科,210029 [2]南京医科大学附属南京儿童医院

出　　处：《临床神经外科杂志》2014年第4期241-243,247,共4页Journal of Clinical Neurosurgery

基　　金：南京市卫生青年人才培养工程第二;三层次(QRX11115;QRX11317)

摘　　要：目的：探讨颅内室管膜下瘤磁共振影像学表现，以期提高对该病的影像学认识水平，有利于术前的诊断。方法回顾性分析9例（我院及外院）经手术病理证实的室管膜下瘤的磁共振影像学资料，并与脑室内其他肿瘤进行鉴别诊断。结果肿瘤位于侧脑室5例，透明隔区2例，三角区2例。瘤体主要呈椭圆形6例，另外3例呈分叶样不规则形。瘤体边界清楚，大小约1．4～4．4 cm。 T1 WI、T2 WI呈等信号4例，3例呈等长T1等长T2信号，2例T1像见短信号，DWI呈略高信号，T2 FLAIR病灶呈较高信号。对比剂增强后肿瘤3例无强化，4例轻度强化，2例中等强化。5例瘤体内见小类圆形囊状改变，2例患者同时伴有梗阻性脑积水。结论颅内室管膜下瘤好发于脑室系统内， MRI平扫T2小囊性变及增强后不强化或轻度强化为其典型表现，接近孟氏孔区病灶可较大，增强后可中等强化，本病易与脑室内其他肿瘤相鉴别，术前能够较为准确地诊断。Objective To investigate the subependymmoma imaging features in order to improve the diagnostic accuracy of the disease .Methods The clinical data of 9 patients confirmed by pathology of subependymmoma imaging data were compared with the other tumors in the central nervous system ,were analyzed retrospectively .Results Tumors were mainly located in the lateral ventricle of 5 cases, septum pellucidum in 2 and the triangle region in 2.Six cases displayed with oval, clear boundary and 3 with irregular boundary .The dimension of the tumors were about 1.4 to 4.4 cm. The tuomrs demonstrated isointensive signal on T 1 WI and T2 WI in 4 cases, 3 hoperintensity on T1WI and T2WI, 2 with hypointensitive signal on T1WI.DWI showed a slightly higher signal ,and hyperintensive signal on T 2 FLAIR.After contrast injection , 3 cases were without enhancement , a slight enhancement in 4 and 2 moderate enhancement .Meanwhile , 5 cases had small cystic degeneration and 2 obstructive hydrocephalus .Conclusions Intracranial subependymomas often occurs in the ventricular system .The typical features on MRI is microcystic change and without enhancement or slight enhancement after contrast injection , near the foramen of Monro ,the tuomors are more larger in size ,and with middle-level enhancement , and easy to make a differentiation from the other tumors in the intraventricular system .It ’ s helpful for the preoperative diagnosis and evaluation .

关 键 词：室管膜下瘤 磁共振 鉴别诊断 

分 类 号：R739.4[医药卫生—肿瘤]