颅内脱髓鞘假瘤的MRI表现  

The MR imaging characteristics of intracranial demyelinating pseudotumors

作　　者：谢长浓[1] 林国太[1] 黄泽光[1] 

机构地区：[1]广东医学院附属医院放射科,广东湛江524001

出　　处：《实用放射学杂志》2015年第1期16-19,共4页Journal of Practical Radiology

摘　　要：目的：探讨颅内脱髓鞘假瘤（DPTs）的 MRI 影像表现。方法回顾性分析10例经临床最终诊断为 DPTs 的 MRI 影像资料,所有患者均行 MRI 平扫,其中9例行增强扫描,7例行扩散加权成像（DWI）,2例行单体素短回波1 H-MRS。结果其中8例患者病灶周围伴有轻~中度水肿,5例表现为多发病灶,3例表现为单发结节灶,2例表现为单发片状病灶。增强扫描中4例为开环形强化,3例为环形强化,1例结节状强化,1例斑片状强化。病灶在 DWI 上均表现为高信号,1 H-MRS 示2例均有 NAA 峰不同程度降低,Cho 峰、Lac 和 Lip 峰升高,1例谷氨酸/谷氨酰胺复合物（Glx 峰）明显升高。结论DPTs 在 MRI 影像上有一定特点,特征性表现为开环形强化,结合 DWI 及1 H-MRS 技术有助于 DPTs 和其他病变鉴别。Objective To characterize the MRI features of demyelinating pseudotumors（DPTs）.Methods MR data of 10 cases clinically proved with DPTs were retrospectively analyzed .All cases were underwent MRI scan ,9 of 10 cases were performed with enhanced MRI,7 cases were underwent diffusion weight imaging（DWI）,2 cases were performed with single voxel short echo 1 H-MRS.Results 8 cases showed lesions with mild to moderate edema,5 cases showed multiple lesions,3 cases were solitary nodular lesions,2 cases were solitary flaky lesions.On enhanced MRI,4 cases presented with open ring like enhancement,3 cases presented ring like enhancement,1 case with nodular enhancement,and 1 case showed patchy enhancement.All lesions showed high signal in DWI.In 1 H-MRS,2 cases demonstrated varying decrease in peaks heights of Nacetylaspartate（NAA）,elevation of the choline（Cho）,the lactate（Lac）and lipids（1ip）.1 case demonstrated evident elevation in peaks height of glutamate/glutamine（Glx）.Conclusion DPTs has some characteristics on MRI, especially as open ring like enhancement.It is helpful to identified DPTs from other lesions when together with DWI and 1 H-MRS.

关 键 词：脱髓鞘假瘤 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]