乳头状胶质神经元肿瘤的MRI表现  

MRI manifestations of papillary glioneuronal tumor

作　　者：王丽娜 吕秀花 侯民羊 王志岗 胥锋信 张莉 唐永强 WANG Li-na;LYU Xiu-hua;HOU Min-yang;WANG Zhi-gang;XU Feng-xin;ZHANG Li;TANG Yong-qiang(Radiology Department,Weapons Industrial Hygiene Research Institute,Xi'an 710065,China;Radiology Department,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]西安兵器工业卫生研究所放射科,西安710065 [2]空军军医大学第一附属医院放射科,西安710032

出　　处：《医疗卫生装备》2020年第5期65-69,共5页Chinese Medical Equipment Journal

摘　　要：目的:分析乳头状胶质神经元肿瘤(papillary glioneuronal tumor,PGNT)的MRI表现,以提高对该病的认识。方法:回顾性分析经手术和病理证实的4例PGNT患者的临床、影像和病理资料,3例同时行MRI平扫加增强扫描,1例仅行MRI增强扫描,对病变部位、大小、形态、边界、性质、信号特点、MRI平扫和增强扫描及病理表现等方面进行综合性分析。结果:4例PGNT均位于幕上,颞叶皮质区、额叶脑室周围白质区、三脑室及鞍区各1例。肿瘤最大径1.7~5.0 cm,3例病变边界较清楚、1例边界不清,肿瘤可呈囊实性(3例)、囊性伴壁结节样(1例)2种形态。平扫病变实性部分以T1WI呈稍低信号、T2WI呈稍高信号为主,囊性区内可见线条状T2WI低信号分隔及T1WI、T2WI低信号斑,增强扫描实性部分及壁结节明显强化,线样分隔呈轻度强化,囊壁可呈无强化、环状轻度强化或明显强化。1例有轻度占位效应,2例瘤周轻度水肿,2例幕上脑室扩张。病理光镜下均可见特征性假乳头样结构。结论:PGNT的MRI表现具有一定特征性,MRI在PGNT的诊断中具有一定价值,确诊还需要病理检查。Objective To analyze the MRI features of papillary glioneuronal tumors(PGNT)so as to enhance its understanding.Methods The clinical,imaging and pathological data of 4 cases of PGNT confirmed by operation and pathology were analyzed retrospectively.There were 3 cases underwent MRI plain scan and enhanced scan at the same time,and 1 case only underwent MRI enhanced scan.The location,size,shape,boundary,nature,signal characteristics,MRI plain scan and enhanced scan and pathological manifestations of the lesions were analyzed comprehensively.Results PGNT was located in the supratentorial area in 4 cases,with one case respectively in temporal cortex area,white matter area around frontal ventricles,third ventricles and sellar area;tumor maximum diameter was restrained within 1.7 and 5.0 cm;there was 1 case had clear boundaries while 3 cases had unclear ones;there were 3 cases of cystic-solid lesions and one case of cyst with a mural nodule tumor;plain scan showed slightly low signal on T1WI and slightly high signal on T2WI mainly found in the solid part of the lesions,line-like low signal separation on T2WI as well as low signal spots on T1WI and T2WI were found in the cystic area;enhancement scan showed the solid part and the wall nodule were obviously enhanced,the line-like separation was slightly enhanced,and non enhancement,slightly rim enhancement or significant enhancement was observed on the cyst wall;there was one case of slight mass effect,2 cases of mild peritumoral edema and another 2 cases of supratentorial ventricular dilatation;the characteristic pseudopapillary structures were observed under the light microscope.Conclusion The MRI manifestations of PGNT have certain characteristics,so MRI has certain values in the diagnosis of PGNT,while pathological examination is needed for the diagnosis.

关 键 词：乳头状胶质神经元肿瘤 MRI 增强扫描 病理 免疫组化 

分 类 号：R318[医药卫生—生物医学工程] R445.3[医药卫生—基础医学]