颅内炎性脱髓鞘假瘤的MRI表现(附11例报告及文献复习)  

MRI features of the intracranial tumefactive demyelinating diseases(11 cases report and literature review)

作　　者：贺伟光 卜姗姗 王维平[1] HE Weiguang;BU Shanshan;WANG Weiping(Department of Radiology,Tianjin Fifth Center Hospital,Tianjin 300450,China)

机构地区：[1]天津市第五中心医院放射科,天津300450

出　　处：《实用放射学杂志》2023年第3期354-358,共5页Journal of Practical Radiology

摘　　要：目的分析颅内炎性脱髓鞘假瘤的MRI特点并文献复习.方法回顾性分析11例经随访证实的颅内炎性脱髓鞘假瘤患者的MRI表现并综述多篇文献报道的影像学特点,11例均行MR平扫及增强检查,1例行三维动脉自旋标记(3D-ASL)检查,1例行扩散张量成像(DTI)检查.结果11例炎性脱髓鞘假瘤患者病灶直径2.0~3.6 cm,平均(2.7±0.55)cm,4例为多发,7例为单发,7例伴有轻度占位效应.9例表现为长T1、长T2信号,2例可见出血,表现为短T2信号.液体衰减反转恢复(FLAIR)序列9例为高信号,2例为低信号.扩散加权成像(DWI)序列9例表现为边缘高、中心低的环形高信号,1例为高信号,1例为等信号.10例增强扫描中4例表现为开环状强化,6例为环形强化,3例呈结节状均匀强化,1例无强化.功能MRI上1例表现为低灌注,1例表现为病变区脑白质纤维束稀疏,各向异性分数(FA)值减低.结论颅内炎性脱髓鞘假瘤MRI表现有一定特征性,病灶多累及皮层下脑白质或侧脑室周围脑白质,可单发或多发,边界清晰,占位效应轻,增强扫描多表现为开环状强化、环形强化或者结节状强化.Objective To analyze the MRI features of intracranial tumefactive demyelinating diseases and to review and summarize the previous literatures.Methods MRI features of 11 patients with intracranial tumefactive demyelinating diseases confirmed by follow-up were analyzed retrospectively.Moreover,the imaging features of intracranial tumefactive demyelinating diseases were summarized based on literatures.All cases underwent MR scan and enhanced examination,including 1 case with three dimensional arterial spin labeling(3D-ASL)and 1 case with diffusion tensor imaging(DTI).Results Among the 11 patients with tumefactive demyelinating diseases,the diameter of lesions ranged from 2.0 to 3.6 cm,with an average of(2.7±0.55)cm.Single lesion was found in 7 cases with mild mass effect,and multiple lesions in 4 cases.A total of 9 cases appeared long T1 and long T2 signals,2 cases appeared hemorrhage with low signal on T2.On fluid attenuated inversion recovery(FLAIR)sequence,9 cases were hyperintensity,2 cases were hypointensity.On diffusion weighted imaging(DWI)sequence,9 cases appeared rim hyperintensity,1 case hyperintensity,and 1 case isointensity.A total of 10 cases showed variable degrees of contrast enhancement with open ring(n=4),ring(n=6),nodular enhancement(n=3),and 1 case showed no enhancement.On functional MRI,1 case showed hypoperfusion,and white matter tracts was displacement and the value of fractional anisotropy(FA)was lower on the other 1 case.Conclusion The MRI of intracranial tumefactive demyelin-ating diseases has some characteristic,including the lesions located subcortical white matter or preventricular white matter with mild mass effect,and the single or multiple lesions with well-defined margin,and with the rim enhancement including open ring,and ring or nodular enhancement.

关 键 词：肿瘤样病变 脱髓鞘病 脑肿瘤 磁共振成像 

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