成人髓母细胞瘤MRI表现及误诊分析  

MRI features of adult medulloblastoma

作　　者：卿时军 江登科 靳瑞娟[1] QING Shi-jun;JIANG Deng-ke;JIN Rui-juan(Department of Medical Imaging,Boai Hospital of Zhongshan,Guangdong 528403,China)

机构地区：[1]中山市博爱医院医学影像科,广东中山528403 [2]湖南中医药大学第二附属医院放射影像科,湖南长沙410005

出　　处：《影像诊断与介入放射学》2022年第5期340-345,共6页Diagnostic Imaging & Interventional Radiology

摘　　要：目的总结分析成人髓母细胞瘤(MB)的MRI影像特征,分析MRI对MB的诊断价值及误诊原因。方法回顾性分析2014年5月~2021年8月我院12例术后经病理证实为髓母细胞瘤的临床及MRI资料,均完成MR平扫加增强及DWI检查,对肿瘤的发病部位、影像特点、病理特征进行总结分析并分析误诊原因。结果本组12例患者中男8例,女4例,年龄18~40岁,中位年龄23岁。7例(58%)患者病灶位于小脑蚓部,中位年龄21岁;5例(42%)患者位于小脑半球,中位年龄35岁。12例患者MRI平扫为T_(1)WI稍低信号,T_(2)WI稍高信号,DWI序列12例实性成分均为高、稍高信号,ADC图为低信号,其中5例(41.7%)可见囊变。5例瘤体前方可见脑脊液环绕。5例表现为双侧侧脑室扩大;增强扫描病灶实性成分强化程度不一。8例行CT扫描,实性成分呈稍高密度,高于正常脑实质密度。结论成人髓母细胞瘤DWI序列扩散受限,实性部分CT平扫密度高;年长病例病灶多位于小脑半球,而年轻成人与儿童病例影像特点类似。Objective To analyze the MRI features of adult medulloblastoma(MB).Methods 12 patients(8 men,4 women;age range:18-40 years,median age:23 years)with pathologically confirmed MB from May 2014 to August 2021 underwent MRI including diffusion-weighted imaging(DWI).The tumor location and MRI features were analyzed respectively.Results The tumor was located in the cerebellar vermis(7,median age of 21 years)and cerebellar hemisphere(5,median age of 35 years).MRI showed slightly low T_(1) and slightly high T_(2) signal intensities with reduced apparent diffusion coefficients(ADC)and variable degree of contrast enhancement in the solid components of tumors.Cystic changes were observed in 5 patients(41.7%).The tumor was surrounded by cerebrospinal fluid anteriorly in 5 patients.Hydrocephalus was found in 5 patients.CT density of the solid components was higher than the normal brain parenchyma in 8 patients who also underwent CT.Conclusion The solid components of adult MB are hyperdense on nonenhanced CT and with reduced diffusion on DWI.The lesions of older adults are mostly located in the cerebellar hemisphere whereas the imaging features of MB in young adults are similar to that of children.

关 键 词：髓母细胞瘤 成人 磁共振成像 扩散加权成像 体层摄影术 X线计算机 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R814.42