三脑室区占位性病变MR影像综合分析  

Comprehensive analysis of space occupying lesions on the third ventricle region by using MR imaging

作　　者：徐志华[1,2] 杨本强[2] 张梦知 蔡晓楠[2] 孙玉[2] 侯洁[2] 段阳[2] XU Zhi-hua YANG Ben-qiang ZHANG Meng-zhi CAI Xiao-nan SUN Yu HOU Jie DUAN Yang(Jinzhou Medical University, General Hospital of Shenyang Military Region Command Training Base for Graduate, Shenyang 110016, China Department of Radiology, General Hospital of Shenyang Military Region, Shenyang 110016, China)

机构地区：[1]锦州医科大学中国人民解放军沈阳军区总医院研究生培养基地,辽宁沈阳110016 [2]中国人民解放军沈阳军区总医院放射科,辽宁沈阳110016

出　　处：《中国临床医学影像杂志》2016年第11期765-769,787,共6页Journal of China Clinic Medical Imaging

基　　金：辽宁省自然科学基金"脑胶质瘤的侵袭性生物学行为的影像学研究"(编号:201102242);辽宁省临床能力建设项目(LNCCC-B06-2014)

摘　　要：目的：综合分析三脑室区占位性病变发病年龄、位置、毗邻关系和影像学特征。方法：综合分析68例病理及随诊证实的三脑室区占位性病变的发病年龄、位置、毗邻关系及影像学特征；分别对肿瘤周围情况（室周组织浸润、水肿）、影像学特点（T2WI、T1WI信号强度、均匀性、强化模式）与肿瘤良恶性进行相关性分析。结果：68例三脑室区占位性病变（前部38例、上部5例、下部3例、后部16例，内部6例）包括非肿瘤性病变14例，肿瘤性病变54例（良性36例，恶性18例）。三脑室区病变中，生殖细胞瘤、LCH多见于儿童及青少年；垂体大腺瘤、乳头状颅咽管瘤、下丘-视交叉神经胶质瘤、转移瘤等多见于中老年；釉质细胞型颅咽管瘤在7~24岁和40~60岁多见，血管性病变发病年龄无明显特异性。单因素分析室周组织浸润、水肿与肿瘤良恶性有关（P〈0.001），T1WI和T2WI信号强度、均匀性、强化模式等与肿瘤良恶性无明显相关（P〉0.05）。结论：综合分析三脑室区占位性病变的发病年龄、位置、毗邻关系和影像学特征有利于诊断及鉴别诊断，以便指导临床治疗。Objective： To analyze comprehensively the age, location, adjacent relationship and MR imaging features of space occupying lesions on the third ventricle region. Methods： Sixty-eight patients with space occupying lesions on the third ventricle region（confirmed by postoperative histopathology, following up） were reviewed in order to analyze their differences of the age, location, adjacent relationship and the MR imaging characteristics in this study. The correlationship between peritumoral appearance（periventricle extension, periventricle edema）, MR imaging feature（T2WI, T1WI signal intensity, uniformity and enhancement pattern） and benign or malignant tumor was analyzed respectively. Results： Of 68 cases with third ventricle region tumor-like lesion（anterior part： 38 cases, upper part： 5 cases, posterior part： 16 cases, floor part： 3 cases, intraventricle： 6 cases）, there included 14 non-neoplasm lesions and 54 tumor lesions（36 benign tumors and 18 malignant tumors）. Germinoma, Langerhans cell histiocytosis（LCH） were seen commonly in children and adolescents; pituitary adenoma, papillary craniopharyngioma, hypothalamic-chiasmatic glioma and metastases were usually seen in middle-aged and old population; adamantinomatous craniopharyngioma were seen in 7 to 24 years old and 40 to 60 years old; the onset age of vascular lesions had no obvious specificity in our study. There was statistically significant difference between periventricle extension, periventricle edema and tumor malignancy, respectively（P〈0.001）. There was no statistically significant difference between T2WI, T1WI signal intensity, uniformity, enhancement pattern and tumor malignancy by single factor analysis（P〉0.05）. Conclusion： Comprehensive analysis of the age, location, adjacent relationship and imaging features of space occupying lesions on the third ventricle region may be helpful to improve their diagnoses and differential diagnoses, so as to guide clinical therapy.

关 键 词：第三脑室 脑疾病 磁共振成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R739.41[医药卫生—临床医学]