髓内室管膜瘤MRI影像表现  

MRI features of intramedullary ependymoma

作　　者：李红敏 钱伟军 LI Hongmin;QIAN Weijun(Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院放射科,河南开封475000

出　　处：《中国实用神经疾病杂志》2018年第8期895-897,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的讨论髓内室管膜瘤的MRI影像特征,帮助提高正确诊断率及定位手术切除范围。方法回顾性分析经手术及病理证实的10例髓内室管膜瘤平扫及增强影像表现分析肿瘤形态大小、部位、生长方式、信号特点及强化方式,有无囊变、出血及"戴帽征",结果全部髓内室管膜瘤呈腊肠状纵行、中心性生长,累及多个椎体,其中颈髓5例,胸髓1例,腰骶段脊髓4例,10例病灶均有囊变,在平扫MRI,T1WI上大部分肿瘤呈混杂低信号,在T2WI上所有肿瘤均呈不均高信号,10例肿瘤头、尾端均有囊变,其中2例瘤内囊变,1例肿瘤灶内出血,在T2WI上5例肿瘤可见"戴帽征",肿瘤两侧的蛛网膜下腔对称性狭窄或闭塞。增强后,10例肿瘤实质部分均表现为不均显著强化,囊变无强化,其中8例肿瘤与正常脊髓分界清楚。结论髓内室管膜瘤在MRI具有一定的特征性表现,能有助于提高髓内室管膜瘤准确诊断及术前认识。Objective To discuss the MRI features of intramedullary ependymoma and to improve the correct diagnosis rate and locate the surgical resection range.Methods A retrospective analysis of plain and enhanced imaging findings of 10 cases with intramedullary ependymoma proved by surgery and pathology was performed,The shape,size,location,growth pattern,signal characteristics and enhancement patterns of the tumor were analyzed,including cystic degeneration,hemorrhage and"cap"sign"were analyzed.Results All intramedullary ependymoma were botuliform longitudinal center of growth,involving multiple vertebral body.There were 5 cases of cervical spinal cord,1 cases of thoracic spinal cord,4 cases of lumbosacral spinal cord,and 10 cases of cystic degeneration.On plain scan MRI and T1WI,most tumors showed mixed low signal,and all tumors showed uneven high signal on T2WI,There were cystic changes in the head and tail of 10 cases,including 2 cases of cystic degeneration and 1 cases of intra tumor hemorrhage;On T2WI,5 cases showed"cap sign",symmetrical stenosis or occlusion of the subarachnoid space on both sides of the tumor.After enhancement,in 10 cases,the parenchymal part of the tumor showed heterogeneous enhancement,cystic degeneration was not enhanced,and 8 of them had clear boundary between the tumor and normal spinal cord.Conclusion Intramedullary ependymoma has some special characteristics in MRI,which can help to improve the accurate diagnosis and preoperative understanding of intramedullary ependymoma.

关 键 词：头尾端囊变 不均强化 戴帽征 髓内室管膜瘤 脊髓空洞症 

分 类 号：R739.45[医药卫生—肿瘤]