多形性黄色星形细胞瘤 MRI 分析  

MRI analysis of pleomorphic xanthoastrocytoma

作　　者：黄云海[1] 郭永梅[1] 江新青[1] 韦程纲[1] 

机构地区：[1]广州市第一人民医院放射科,广东 广州510180

出　　处：《实用放射学杂志》2015年第10期1593-1597,共5页Journal of Practical Radiology

摘　　要：目的：探讨多形性黄色星形细胞瘤（PXA）的 MRI 特征及影像鉴别诊断价值。方法回顾性分析15例经手术病理证实为 PXA 的 MRI 图像,分析其临床病史、病变部位、大小、形态、信号、增强表现及邻近结构表现等影像表现,结合文献分析该病 MRI特征。结果15例病变均为幕上单发,其中颞叶9例（占60%）；14例与软脑膜接触,1例与侧脑室壁接触。病变均为囊实性,囊实性部分比例不一,8例较大病变以囊性为主（53.3%）,3例较小的病变以实性为主（20%）,4例病变囊实性部分比例大致相当（26.7%）。肿瘤实性部分呈 T1 WI 中等或稍低信号、T2 WI 中等或稍高信号,增强扫描显著强化；囊液信号部分略高于脑脊液。7例可见囊壁或分隔线状强化；8例可见病变接触的软脑膜异常强化。结论PXA 的 MRI 特征为：颞叶多见、与软脑膜接触的脑内囊实性肿块,典型表现为“大囊伴附壁结节”或“多囊伴不规则偏心性实性结节”,实性部分显著强化。MRI 特征对 PXA 诊断及鉴别诊断有实用价值。Objective To investigate the MRI features of pleomorphic xanthoastrocytoma （PXA）.Methods 1 5 pathologically confirmed PXA cases were analyzed retrospectively.Clinical history and imaging features including location,size,shape,signal intensi-ty,enhancement and surrounding changes of those lesions were analyzed.Results All 1 5 cases were supratentorial and solitary le-sions,of which 9 lesions located in temporal lobe（60%）.14 lesions contacted with the leptomeninges,and 1 lesion contacted with lat-eral ventricle wall.All lesions were solid-cystic,with different proportion of solid/cystic components.8 large lesions were predomi-nantly cystic（53.3%）,3 small lesions were predominantly solid（20%）,and 4 lesions had roughly equal cystic and solid proportions （26.7%）.Solid components showed iso-intense or mild hypo-intense on T1 WI,iso-intense or mild hyper-intense on T2 WI,and signif-icant enhancement with contrast.Cyst fluid showed slightly hyper-intense in some cases.Cyst wall or septa enhancement was seen in 7 cases,and leptomeningeal enhancement was seen in 8 cases.Conclusion The MRI features of PXA are the characteristic of suprat-entorial solid-cystic lesions commonly seen in temporal lobe and contacting with leptomeninges.The typical features include “cyst with mural nodule”and “multiple cysts with irregular eccentric nodule”with significant enhancement of solid component and some cyst wall.MRI features of PXA is valuable in diagnosis and differential diagnosis of PXA.

关 键 词：多形性黄色星形细胞瘤 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]