儿童不典型毛细胞型星形细胞瘤的影像学表现  

Imaging diagnosis of atypical pilocytic astrocytoma in children

作　　者：吴寒 盛会雪 边传振 何俊平[2] 顾海斌 WU Han;SHENG Huixue;BIAN Chuanzhen;HE Junping;GU Haibin(Department of Radiology,Children’s Hospital of Nanjing Medical University,Nanjing 210008,China;Department of Neurosurgery,Children’s Hospital of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院放射科,江苏南京210008 [2]南京医科大学附属儿童医院神经外科,江苏南京210008

出　　处：《实用放射学杂志》2023年第10期1669-1672,共4页Journal of Practical Radiology

摘　　要：目的探讨儿童不典型毛细胞型星形细胞瘤(PA)的影像学特点。方法回顾性分析9例经病理证实的不典型PA影像学表现。患儿均行头颅MRI检查,增强7例;8例行头颅CT检查,增强6例。结果9例病变均单发。(1)6例位于鞍区,表现为类圆形或分叶状占位,5例为囊实性,1例为实性。CT平扫实性成分呈等或稍低密度,囊性成分呈低密度。MRI平扫实性成分呈稍长T_(1)长T_(2)信号,实性成分明显强化。2例合并瘤周蛛网膜囊肿;2例合并幕上脑室系统扩张。(2)3例位于大脑半球表浅部位,均为实性肿块,均可见钙化,1例可见瘤内出血。MRI均未见扩散受限。1例呈结节状轻度强化,1例呈环状强化。结论不典型PA好发于鞍区及大脑半球表面。鞍区PA为囊实性或实性肿块,钙化及出血少见,实性成分明显强化。瘤周继发性蛛网膜囊肿是其特征性表现。大脑半球PA为实性肿块,钙化及出血常见,占位效应不明显,肿瘤强化范围和程度不如鞍区PA明显。Objective To investigate the imaging characteristics of children with atypical pilocytic astrocytoma(PA).Methods The imaging findings of 9 cases with atypical PA confirmed by pathology were analyzed retrospectively.MRI and CT were undergone in 9 and 8 patients,MRI and CT enhanced scans were undergone in 7 and 6 cases,respectively.Results All the 9 cases had single lesions.(1)6 cases were located in the saddle area with rounded or lobulated margins.5 cases presented cystic solid mass,and 1 case had solid mass.On CT plain scan,the density of solid components presented equal or slightly low density,while cystic components showed low density.MRI examination showed that the solid components were equal or slightly long T_(1),long T_(2) signal.The solid components were obviously enhanced.2 cases were complicated with peritumoral arachnoid cyst,while 2 cases had supratentorial ventricular system dilation.(2)3 cases were located in the superficial part of the cerebral hemisphere.All the patients presented with solid mass.3 cases showed calcification,1 case showed intra-tumoral bleeding.Diffusion limited was not presented.Nodular and annular enhancement in MRI enhanced scan were respectively showed in 1 case.Conclusion Atypical PA tends to occur in the saddle area and the cerebral hemisphere.PA in saddle area is most cystic or solid mass,and calcification and bleeding are rare.The solid components are significantly enhanced.Peri-tumoral secondary arachnoid cyst formation is its characteristic feature.PA in cerebral hemisphere is mostly solid mass,calcification and bleeding are common,and the mass effect is not obvious.The extent and degree of tumor enhancement on enhanced scan are not as obvious as PA in saddle area.

关 键 词：毛细胞型星形细胞瘤 儿童 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] R445.2