幕上毛细胞星形细胞瘤的MR表现及误诊分析  

MR findings and misdiagnosis of supratentorial pilocytic astrocytoma

作　　者：郑长宝 黄聪 黄波涛 王宇军[4] 邓明明 ZHENG Chang-bao;HUANG Cong;HUANG Bo-tao;WANG Yu-jun;DENG Ming-ming(Department of Radiology,Hainan Cancer Hospital,Haikou 570100,China;Department of Radiology,the 926 Hospital of PLA,Kaiyuan Yunnan 661699,China;Department of Radiology,Houjie Hospital Affiliated Guangdong Medical University,Dongguan Guangdong 523945,China;Department of Radiology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]海南省肿瘤医院放射科,海南海口570100 [2]中国人民解放军联勤保障部队第九二六医院放射科,云南开远661699 [3]广东医科大学附属东莞厚街医院放射科,广东东莞523945 [4]浙江省立同德医院放射科,浙江杭州310012

出　　处：《中国临床医学影像杂志》2021年第10期704-707,共4页Journal of China Clinic Medical Imaging

基　　金：浙江省医药卫生科技计划项目(No.2019319609)。

摘　　要：目的:探讨幕上毛细胞型星形细胞瘤(Pilocytic astrocytoma,PA)的MR特点并分析其误诊原因。方法:回顾性分析9例经病理证实为幕上PA的临床及MR资料,分析其误诊原因。结果:9例均为单发病灶,实性型2例,囊实性型1例,囊结节型5例,囊性型1例。结节或实性瘤体T1WI呈低信号,T2WI及T2 FLAIR以高信号为主,信号可混杂不等,DWI呈等或低信号。增强强化方式多样,4例表现为Ⅰ型,2例表现为Ⅱ型,1例表现Ⅲ型,1例表现为Ⅳ型,1例为Ⅴ型。9例术前均误诊,2例误诊为多形性黄色星形细胞瘤,1例误诊为室管膜下瘤,1例误诊为血管母细胞瘤,1例误诊为节细胞胶质瘤,1例误诊为脑膜瘤,1例误诊为弥漫性星形细胞瘤,1例误诊为间变性星形细胞瘤,1例误诊为少突胶质细胞瘤。结论:幕上PA少见,MR表现有其自身的影像特点,表现不典型时,完善检查序列有助于其鉴别诊断。Objective:To investigate the MR features of supratentorial pilocytic astrocytoma(PA)and analyze the causes of misdiagnosis.Methods:The clinical and MR data of 9 cases of supratentorial PA confirmed by pathology were analyzed retrospectively,and the causes of misdiagnosis were analyzed.Results:All the 9 cases were solitary lesions,2 cases were solid type,1 case was cystic solid type,5 cases were cystic nodular type,and 1 case was cystic type.Nodules or solid tumors showed hypointensity on T1WI,hyperintense on T2WI and T2 FLAIR,mixed signal intensity and iso-or low signal intensity on DWI.There were various ways of enhancement,including 4 cases of typeⅠ,2 cases of typeⅡ,1 case of typeⅢ,1 case of typeⅣand 1 case of typeⅤ.Nine cases were misdiagnosed,2 cases were misdiagnosed as pleomorphic xanthoastrocytoma,1 case was misdiagnosed as subependymal tumor,1 case was misdiagnosed as hemangioblastoma,1 case was misdiagnosed as ganglioglioma,1 case was misdiagnosed as meningioma,1 case was misdiagnosed as diffuse astrocytoma,1 case was misdiagnosed as anaplastic astrocytoma,1 case was misdiagnosed as oligodendroglioma.Conclusion:Supratentorial PA is rare,but there are imaging features on MRI.When the manifestation is not typical,improving the examination sequence is helpful for its differential diagnosis.

关 键 词：星形细胞瘤 磁共振成像 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]