毛细胞黏液样星形细胞瘤临床及影像学特点  

Clinical and imaging characteristics of pilomyxoid astrocytoma

作　　者：李正然[1] 沈慧聪[1] 常天静 范亦龙[1] 艾林[1] 马军[1] 戴建平[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经影像中心,北京100050

出　　处：《中国医学影像技术》2015年第11期1630-1634,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的分析毛细胞黏液样星形细胞瘤(PMA)的临床及影像学特征。方法回顾性分析35例经手术、病理及免疫组化证实的PMA患者的临床特点及影像学表现。结果PMA主要位于下丘脑-视交叉-3脑室区域(23/35,65.71%),其次为大脑半球(6/35,17.14%)。CT扫描多为稍低密度(23/28,82.14%)和等密度(2/28,7.14%),因出血呈高密度3例(3/28,10.71%);合并少许点状、线状钙化9例。MR扫描边界清晰30例(30/31,96.78%);无瘤周水肿28例(28/31,90.32%),轻度水肿3例(3/31,9.68%)。T1WI实性部分为不均匀稍低信号28例(28/31,90.32%)。T2WI为高信号伴絮片状稍高信号26例(26/31,83.87%),均匀高信号1例(1/31,3.23%),不均匀等信号2例(2/31,6.45%),因出血为低信号2例(2/31,6.45%);瘤体内见点、线状等信号27例(27/31,87.09%)。增强扫描,实性部分明显强化27例(27/30,90.00%),轻度点线状强化1例(1/30,3.33%),无强化2例(2/30,6.67%);实性部分包含无强化区28例(28/30,93.33%),柔脑膜强化5例(5/30,16.67%)。结论 PMA影像学表现具有一定特征性,结合临床及CT、MRI特征,可提高术前诊断的准确性。Objective To analyse the clinical and imaging features of pilomyxoid astrocytomas（PMAs）.Methods CT/MR images and medical records of 35 patients with PMAs were retrospectively reviewed.All tissue samples were independently reviewed for confirmation of pathologic diagnosis.Results PMAs were mainly located in the chiasmatic-hypothalamic-3rd ventricular region（23/35,65.71%）,the second were located in the cerebral hemisphere（6/35,17.14%）.On CT scans,most PMAs showed iso-hypodense（23/28,82.14%）and isodense（2/28,7.14%）,3cases（3/28,10.71%）showed hyperdense because of hemorrhage,9cases with linear and punctuate calcifications.On MR scans,30cases（30/31,96.78%）appeared well-circumscribed,28cases（28/31,90.32%）had no peritumoral edema,another 3cases（3/31,9.68%）had mild edema.The solid portions of 28cases（28/31,90.32%）were heterogeneous iso-hypointense on T1 WI and 26cases（26/31,83.87%）were hyperintense with patchy iso-hyperintense on T2 WI,1case（1/31,3.23%）was homogeneous hyperintense,2cases（2/31,6.45%）were heterogeneous isointense,2cases（2/31,6.45%）showed hypointense because of hemorrhage.27cases（27/31,87.09%）with linear and punctuate isointense.Upon contrast administration,the solid portions of 27PMAs（27/30,90.00%）enhanced intensely,1PMA（1/30,3.33%）enhanced slightly,2cases（2/30,6.67%）had no enhancement.28cases（28/30,93.33%）containing solid mass included non-enhancing portion.Leptomeningeal enhancement was noted in 5cases（5/30,16.67%）.Conclusion The imaging features and clinical characteristics of PMAs can be used to improve the accuracy of preoperative diagnosis.

关 键 词：星形细胞瘤 磁共振成像 体层摄影术 X线计算机 

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