丘脑原发性肿瘤的影像学诊断价值分析  

Imaging diagnostic value of primary thalamic tumors

作　　者：薛克勤 徐朝霞 张明[1] 王渊[1] XUE Keqin;XU Zhaoxia;ZHANG Ming;WANG Yuan(Department of Radiology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Radilogy,986 Hospital of the Air Force,Xi'an 710054,China)

机构地区：[1]西安交通大学第一附属医院影像科,陕西西安710061 [2]空军第986医院影像科,陕西西安710054

出　　处：《实用放射学杂志》2020年第7期1023-1026,共4页Journal of Practical Radiology

摘　　要：目的 总结丘脑原发性肿瘤的影像学表现,以期提高诊断准确率.方法 回顾性分析接受外科手术和/或试验性治疗的54例丘脑原发性肿瘤的影像学表现,包括部位、形态、大小、瘤内囊变、出血及钙化、瘤周水肿、强化特点及功能成像特点.结果 毛细胞星形细胞瘤表现为囊实性病变;Ⅱ级星形细胞瘤呈均质稍低密度、稍长T1稍长T2信号,不强化;间变型星形胶质细胞瘤和胶质母细胞瘤坏死明显,不规则环形强化;少突胶质细胞瘤除钙化明显外,影像学表现与星形胶质细胞瘤类似;节细胞胶质瘤与毛细胞星形细胞瘤不易区分,但不强化;生殖细胞瘤青少年多见,出血明显;淋巴瘤的密度、信号均匀,均质明显强化;畸胎瘤信号混杂,可含有脂肪、钙化;海绵状血管瘤常有含铁血黄素环.结论 CT显示丘脑肿瘤内钙化、脂肪和急性期出血相对特异,MRI能够全面显示瘤内各种组织成分和代谢异常,两者联合使用可提供丘脑原发性肿瘤的关键影像学信息,提高诊断符合率.Objective To improve the diagnostic accuracy for primary thalamic tumors by summarizing the imaging features of the lesions.Methods 54 cases of primary thalamic tumors confirmed by surgery or experimental treatment were retrospectively reviewed to analyze the imaging manifestations,including the location,shape,size,cystic degeneration,hem orrhage,calcification,peritum oraledema,enhancement pattern,and functional imaging characteristics.Results Pilocytic astrocytoma showed cystic-solid lesions.A strocytoma of grade Ⅱ showed homogeneous,slightly low density,slight hypointensity on T1WI and hyperintensity on T2WI without enhancement.Obvious necrosis with irregular ring-enhancement frequently occurred in anaplastic astrocytoma and glioblastoma.The imaging presentations of oligodendroglioma were similar to astrocytoma except for the significant calcification.It was relatively difficult to differentiate ganglioglioma from pilocytic astrocytoma,but ganglioglioma usually showed no enhancement.Germ inom a commonly occurred in adolescents with obvious hemorrhagic lesions.Lymphoma presented with homogeneous density and signal intensity with significantly homogeneous enhancement.Teratoma always showed mixed density and signal intensity due to complex components including the fat and calcification.“Hemosiderin ring”on T2WI was a distinctive MRI feature of cavernous hemangioma.Conclusion Calcification,fat and acute hem orrhage of prim ary thalamic tum ors are relatively specific on CT im ages,while diverse com ponents and metabolic abnorm ality of the tum ors could be dem onstrated comprehensively through MRI.The combination of two types of examinations could provide key imaging inform ation to improve the diagnostic accuracy for primary thalamic tumors.

关 键 词：丘脑 原发性肿瘤 计算机体层成像 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R814.42[医药卫生—临床医学]