不同级别脉络丛肿瘤的MRI表现与病理对照分析  

Choroid Plexus Tumors of Different Grades:Correlation between MRI and Pathologic Findings

作　　者：林欢[1] 冷西 张弛[1] 覃春红[1] 邱士军[1] LIN Huan LENG Xi ZHANG Chi et al(Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province 510515, P. R. China)

机构地区：[1]南方医科大学南方医院影像中心,广州510515

出　　处：《临床放射学杂志》2017年第2期166-170,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81271389)

摘　　要：目的探讨不同级别脉络丛肿瘤MRI表现的异同与组织病理学的关系。方法回顾性分析经手术病理证实的20例脉络丛肿瘤患者的临床、病理与影像资料,其中脉络丛乳头状瘤(WHOⅠ级)10例,非典型脉络丛乳头状瘤(WHOⅡ级)5例,脉络丛癌(WHOⅢ级)5例。结果 20例脉络丛肿瘤中18例位于脑室系统内。WHOⅠ、Ⅱ、Ⅲ级瘤体长径的中位数分别为28.4 mm、44.6 mm、60.2 mm。6例表现为乳头状结构,10例为分叶状结构,2例为团块状结构,2例影像学未见明显实性肿块。瘤体T_1WI呈等或稍低信号,T_2WI呈稍高信号,增强扫描均呈明显强化。7例可见瘤周水肿。10例并发不同程度的脑积水。脉络丛肿瘤的病理分级与瘤体长径(P=0.003)、乳头状结构(P=0.048)、瘤周水肿(P=0.004)的关联有统计学意义。结论脉络丛肿瘤的MRI典型表现为脑室系统内乳头状、分叶状占位性病变,常伴有不同程度的脑积水;瘤体长径越长,乳头状结构变短、模糊,出现瘤周水肿可能是肿瘤恶性程度增加的表现。Objective To investigate the correlation between MRI and pathologic findings of choroid plexus tumors of different grades. Methods The clinical,pathologic and MRI data of 20 surgical pathology proven choroid plexus tumor cases were analyzed retrospectively. The tumors included 10 choroid plexus papillomas（ WHO grade Ⅰ）,5 atypical choroid plexus papillomas（ WHO grade Ⅱ）,and 5 choroid plexus carcinomas（ WHO grade Ⅲ）. Results Eighteen of the20 choroid plexus tumors were located in the ventricular system. The median tumor sizes of the WHO grade Ⅰ、Ⅱ、Ⅲ were28. 4 mm,44. 6 mm,60. 2 mm respectively. Six cases had a papillary appearance; 10 had a lobulated appearance; 2 had a massive appearance; 2 showed no obvious solid mass on images. T1 WI displayed an iso- or slightly low signal intensity;T2WI showed slightly high signal intensity; contrast enhancement was noted in all cases. Peritumoral edema presented in 7cases. Ten cases were accompanied by degrees of hydrocephalus. The pathological grades of choroid plexus tumors were statistically associated with tumor size（ P = 0. 003）,papillary pattern（ P = 0. 048）,peritumoral edema（ P = 0. 004）.Conclusion Choroid plexus tumors typically appeared as papillary or lobulated lesions within the ventricular system,often accompanied by varying degrees of hydrocephalus. Larger tumor,indistinct papillary pattern,presentation of peritumoral edema might indicate malignity.

关 键 词：脉络丛肿瘤 磁共振成像 病理学 

分 类 号：R739.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]