透明隔区肿瘤临床特点及MRI表现  

Clinical and MRI Features of Tumors of Septum Pellucidum

作　　者：郝妮娜[1] 靳松[1] 韩彤[1] 李立[1] 崔世民[1] HAO Ni＇na;JIN Song;HAN Tong;LI Li;CUI Shimin(Department of Medical Image,Huanhu Hospital,Tianjin 300222,China)

机构地区：[1]天津市环湖医院医学影像科,天津300222

出　　处：《肿瘤防治研究》2018年第8期555-559,共5页Cancer Research on Prevention and Treatment

摘　　要：目的探讨透明隔区肿瘤患者的临床特点及MRI表现。方法回顾性分析经手术及病理证实的45例透明隔区肿瘤患者临床资料。结果 45例透明隔区肿瘤,其中中枢神经细胞瘤(central neurocytoma,CNC)33例,星形细胞瘤6例,室管膜肿瘤2例,生殖细胞肿瘤2例,脑膜瘤和淋巴瘤各1例。头痛伴恶心、呕吐为最常见临床表现。术中见所有病灶均与透明隔粘连。MRI显示病灶均位于透明隔区,所有病灶在T1WI显示为等或低信号,T2WI为等或高信号,信号均匀或不均匀。增强扫描呈不同类型的特征性强化方式,CNC多呈不均匀轻-中度强化,19例病灶内可见血管流空;低级别星形细胞瘤实质部分呈轻度强化,高级别肿瘤呈明显环形强化或蝴蝶样强化;室管膜下瘤不强化;室管膜瘤呈明显不均匀强化;生殖细胞瘤、脑膜瘤和淋巴瘤均呈明显均匀强化。此外CNC和高级别星形细胞瘤磁共振波谱成像(MRS)显示NAA降低,Cho升高,灌注成像r CBV升高;脑膜瘤MRS显示Cho峰明显升高,缺乏NAA峰和Cr峰,同时出现Ala峰,灌注成像r CBV明显升高。结论透明隔区肿瘤的MRI表现具有特征性和异质性,结合临床和多序列MRI表现可以初步判断良恶性肿瘤,指导临床制订手术及治疗方案。Objective To investigate the clinical and magnetic resonance imaging（MRI） features of the tumors of septum pellucidum. Methods We analyzed retrospectively the clinical data of 45 patients with the tumors of septum pellucidum confirmed by operation and pathology. Results These tumors of septum pellucidum included 33 cases of central neurocytoma（CNC）, 6 cases of astrocytoma, 2 cases of ependymoma, 2 cases of germ-cell tumor, 1 case of meningioma and 1 case of lymphoma. Headache accompanied with nausea and vomiting was the most common clinical manifestation. All the lesions were adhered to the septum pellucidum. MRI showed all the lesions were located in the septum pellucidum region, equal or short signal on T1 WI and equal or long signal on T2 WI, with even or uneven signals. The enhanced scans demonstrated different characteristics. CNC showed unevenly mild to moderate enhancement, and 19 cases of vascular flow void was observed. The low-grade astrocytomas showed mild enhancement in the parenchyma, while the high-grade astrocytomas showed obvious intensification or butterfly-like enhancement; no enhancement was found in subependymoma whereas significantly heterogeneous enhancement was observed in ependymoma; germ cell tumor, meningioma and lymphoma possessed significantly uniform enhancement. In addition, the magnetic resonance spectroscopy（MRS） of CNC and high-grade astrocytomas showed decreased NAA, increased Cho and increased r CBV of perfusion imaging. MRS with a significantly increased Cho peak, lack of NAA peak and Cr peak, but an Ala peak were observed in meningiomas, together with an obviously increased r CBV in perfusion imaging. Conclusion The MRI of the tumors of septum pellucidum is characteristic and heterogeneous. Combined with clinical symptom and multiple sequence MRI, it is feasible to make a preliminary judgement of the pathology and to guide the clinical decision of the surgery and treatment plan.

关 键 词：透明隔区 磁共振成像 中枢神经细胞瘤 

分 类 号：R739.41[医药卫生—肿瘤]