颅内肿瘤脑脊液播散的 MRI 表现及影响因素  

MRI features and influencing factors of cerebrospinal fluid disseminations of intracranial tumors

作　　者：朱芳梅[1] 丁菊容 袁建华[3] 毛德旺[3] 蒋弘阳 丁忠祥[3] 

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]四川理工学院,四川自贡643000 [3]浙江省人民医院放射科,浙江杭州310014

出　　处：《实用放射学杂志》2017年第2期165-168,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目（81401482）;浙江省自然科学基金项目（LY16H180007,LY13H180016）;浙江省医药卫生科技计划项目（2013RCA001,201342245）.

摘　　要：目的：分析颅内肿瘤脑脊液播散的 MRI 表现及影响脑脊液播散的因素。方法回顾性分析经临床和（或）手术病理证实的33例颅内肿瘤脑脊液播散患者 MRI 资料。所有患者均进行平扫和增强 MRI 检查。结果按播散病灶的分布进行分类：软脑脊膜-蛛网膜型平扫显示2例阳性，增强8例阳性；室管膜下型平扫显示9例阳性，增强8例阳性；混合型平扫显示8例阳性，增强17例阳性。按播散病灶的大小进行分类：线状增厚型平扫显示均为阴性，增强9例阳性；结节型平扫显示18例阳性，增强9例阳性；混合型平扫显示1例阳性，增强15例阳性。结论MRI 增强扫描能够充分显示颅内肿瘤脑脊液播散的特点，并可对播散灶按分布及大小进行分型。手术、原发肿瘤部位与级别等是影响脑脊液播散的主要因素。高、低级别的颅内肿瘤均可发生脑脊液播散，以高级别肿瘤多见。Objective To analyze MRI features and influencing factors of cerebrospinal fluid disseminations of intracranial tumors. Methods MRI data of 33 patients with cerebrospinal fluid disseminations of intracranial tumors confirmed by clinical data and/or surgical pathology were analyzed retrospectively.Conventional and enhanced MRI scan were performed in all 33 cases.Results 33 patients were divided into 3 types according to the distribution of disseminated lesions：the pia-arachnoid type was showed in 2 cases on conventional MRI,and 8 cases on enhanced MRI;subependymal type was showed in 9 cases on conventional MRI,and 8 cases on enhanced MRI;mixed type was showed in 8 cases on conventional MRI,and 1 7 cases on enhanced MRI.33 cases were divided into 3 types according to the size of disseminated lesions：linear type was not showed on conventional MRI,but showed in 9 cases on enhanced MRI;nodular type was showed in 18 cases on conventional MRI,and 9 cases on enhanced MRI;mixed type was showed in 1 case on conventional MRI, and 1 5 cases on enhanced MRI.Conclusion Enhanced MRI scan can fully show characteristics of cerebrospinal fluid disseminations and can classify the lesions in the distribution and size.The main influencing factors of cerebrospinal fluid disseminations are surgery, the location of the primary tumor and the grade of the primary tumor.Both high-grade and low-grade primary tumors may develop cerebrospinal fluid disseminations,it is more common in high-grade tumors.

关 键 词：脑肿瘤 脑脊液播散 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]