颅内软骨瘤的影像表现及病理对照  

Image performances and pathology of intracranial chondroma

作　　者：钱超超 胡广柱 QIAN Chaochao;HU Guangzhu(Radiology Department of Hangzhou Children＇s Hospital,Hangzhou 310014,P.R.China;Radiology Department of Hangzhou First People＇s Hospital,Hangzhou 310006,P.R.China)

机构地区：[1]杭州市儿童医院放射科,浙江杭州310014 [2]杭州市第一人民医院,浙江杭州310006

出　　处：《医学影像学杂志》2018年第11期1791-1794,共4页Journal of Medical Imaging

摘　　要：目的探讨颅内软骨瘤的影像学特征及病理特点,以提高对该病诊断准确性。方法回顾性分析经手术病理证实的7例颅内软骨瘤影像表现及病理特点。所有病例均行MRI平扫及增强扫描,其中4例另行CT平扫。结果病灶呈类圆形、哑铃状或形态不规则,可见分叶,边界清楚,周围无明显水肿。MRI上病灶呈混杂信号,5例呈长T1长T2为主的混杂信号,2例呈稍长T1长T2信号,内见点条状、弧形或不规则长T1短T2或短T1短T2钙化影,增强扫描病变边缘呈环形强化,内部呈蜂窝状不均匀强化; CT上病灶密度不均匀,其内点条状、弧形及不规则钙化,相邻骨质可见侵蚀性破坏。病理上肿瘤由软骨组织构成,细胞分化成熟,异型性不明显,核分裂像难见。免疫组化:S-100(+～++),Vimntin(+),EMA(-)。结论颅内软骨瘤的影像表现具有一定的特征性,MRI联合CT可提高诊断准确率,确认仍依赖于病理。Objective To investigate the imaging features and pathological features of intracranial chondroma in order to improve the diagnostic accuracy. Methods The imaging features and pathological features of 7 cases of intracranial osteochondroma proved by pathology were analyzed retrospectively. All cases underwent MRI scan and enhanced scan, of which 4 cases underwent plain scan with CT scan. Results The shape of lesions showed mound round, dumbbell shaped or irregular, which presented with clear border and no obvious edema. The lesions showed mixed signal on MRI, 5 cases showed long T 1 and long T 2, 2 cases were slightly long T 1 and long T 2 signal, the calcified element of the tumor showed hypointense signal on T 1 and T 2 weighted images or hyperintense signal on T 1 and hypointense signal on T 2 weighted images. The enhanced scan showed an annular enhancement on the margin of the lesion and honeycombed with heterogeneous reinforcement of the interior. The density of lesions on CT was uneven. There were spots, arcs and irregular calcification in the lesion, and adjacent bones showed invasive destruction. Pathologically, the tumor was composed of cartilaginous tissue, atypia was not obvious, mitoticless. Tumor cells showed positive both S-100 and Vimentin, negative for EMA. Conclusion The imaging features of intracranial osteochondroma have some characteristics, MRI combined with CT can improve the diagnostic accuracy, and the final diagnosis is still dependent on pathological and immunohistochemical examinations.

关 键 词：颅内软骨瘤 体层摄影术 X线计算机 磁共振成像 病理 

分 类 号：R739.41[医药卫生—肿瘤] R445[医药卫生—临床医学]