成人与儿童髓母细胞瘤的MRI特征分析  

Magnetic resonance imaging features of medulloblastoma in adults and children

作　　者：叶红[1] 潘海锋[1] 陈秀英[2] 庞华理 王朝文[1] 黄小茹[1] 邓虹[2] 谢明伟[2] Ye Hong;Pan Haifeng;Chen Xiuying;Pang Huali;Wang Chaowen;Huang Xiaoru;Deng Hong;Xie Mingwei(Department of Radiology,Guangdong Nongken Central Hospital,Zhanjiang 524002,China)

机构地区：[1]广东省农垦中心医院医学影像科,广东省湛江市524002 [2]中山大学孙逸仙纪念医院放射科

出　　处：《中华解剖与临床杂志》2018年第4期293-297,共5页Chinese Journal of Anatomy and Clinics

摘　　要：目的 分析成人与儿童髓母细胞瘤的MRI表现,提高对髓母细胞瘤的认识.方法 回顾性分析2009年1月—2017年12月广东省农垦中心医院经手术病理证实的髓母细胞瘤36例的影像学资料.将其分为两组：儿童组（〈18岁）25例,成人组（≥18岁）11例.36例患者术前行MRI平扫及增强扫描,观察并对比分析两组患者肿瘤的发生部位、瘤体最大径线、边界、囊变、实性部分强化程度、瘤周水肿、梗阻性脑积水、室管膜种植转移等影像学特征.结果 36例髓母细胞瘤均发生于幕下,儿童常见于小脑蚓部（21/25）,成人病灶多位于小脑半球（9/11）,差异有统计学意义（P=0.000）.儿童肿瘤最大径为（4.50±0.58）cm,其中17例肿瘤最大径超过4 cm;成年人瘤体最大径为（5.24±1.36）cm,其中8例肿瘤最大径超过4 cm;两者比较差异无统计学意义（Z=-0.895,P〉0.05）.成人组和儿童组囊变分别有16例和11例,瘤周水肿分别有4例和7例,差异均有统计学意义（P=0.034、0.008）;而边界、梗阻性脑积水及室管膜种植转移方面组间差异均无统计学意义（P值均〉0.05）.36例患者髓母细胞瘤实性部分均表现为T2 WI及T2 WI-FLAIR稍高信号,T1 WI等偏低信号.12例做了弥散加权成像检查（5例儿童、7例成人）,瘤体实性部分均表现为弥散受限;增强后,两组肿瘤实性区域均表现为轻度至中度强化.结论 儿童髓母细胞瘤好发于小脑蚓部,成人以小脑半球多见;儿童肿瘤囊变及瘤周水肿相对于成年人少.儿童与成人髓母细胞瘤均常表现为边界清楚肿块,实性区域轻度至中度强化,易发生梗阻性脑积水,可发生室管膜种植转移.Objective To analyze the MRI features findings of adults and children with medulloblastoma for the improvement of the understanding of medulloblastoma. Methods Retrospective analysis of 36 patients with medulloblastoma confirmed by pathology in Guangdong Nongken Central Hospital was conducted, and these patients were divided into two groups：25 patients in the children group and 11 patients in the adult group, followed by undergoing plain and contrast-enhanced MRI. Then the MRI features including the tumor location, the maximum diameter of the tumor, the boundary, cystic changes, parenchymal region enhancement, peritumoral edema, obstructive hydrocephalus, and ependymal-implantation migration were observed and compared. Results The medulloblastoma in all patients located in infratentorial area, and the tumors in children were commonly found in vermis （21/25）, while adult lesions were mostly presented in the cerebellar hemisphere （9/11）, with significant differences （P=0. 000）. In the adult group, cystic changes （ 11/11 ） and peripheral edema （ 7/11 ） were higher than those in the children group （16/25） and edema （4/25）. The differences in the tumor cystic lesions and peritumoral edema were statistically significant in the both groups （P=0. 034, P=0. 008）. The maximum diameter of children patients＇ tumors was （4. 50 ± 0. 58） cm, and the maximum data was more than 4 cm in 17 patients;the maximum diameter of adults patients＇ tumors was （5. 24 ± 1. 36） cm, and it was more than 4 cm in 8 patients, with statistical significance （Z= -0. 895, P〉0. 05）. There was no significant difference in boundary, obstructive hydrocephalus, and ependymal-implantation migration between the two groups （ all P values〉0. 05）. The MRI of parenchymal region in all patients with medulloblastoma showed a slightly higher signal on T2 WI and T2-FLAIR, and a low signal on T1 WI. And 12 patients underwent diffusion-weighted imaging examination （5 children and 7 adults）, and the parenc

关 键 词：髓母细胞瘤 颅脑肿瘤 磁共振成像 影像学表现 成年人 儿童 

分 类 号：R739.4[医药卫生—肿瘤] R445.2[医药卫生—临床医学]