儿童脑膜瘤CT和MRI影像表现分析(附14例病例)  

CT and MR Manifestations of Meningioma in Children: A Report of 14 Cases

作　　者：曾伟彬[1] 张欢[2] 罗珍[3] 李鹏[1] 曹卫国[1] ZENG Weibin;ZHANG Huan;LUO Zhen(Department of Radiology,Shenzhen Children's Hospital,Shenzhen,Guangdong Province 518038,P.R.China)

机构地区：[1]深圳市儿童医院放射科,518038 [2]深圳市儿童医院病理科,518038 [3]深圳市儿童医院皮肤科,518038

出　　处：《临床放射学杂志》2024年第5期823-826,共4页Journal of Clinical Radiology

基　　金：深圳市医疗卫生三名工程项目资助项目(编号:SZSM202011005);深科技创新资助项目【2022】47号(编号:JCYJ20220530155607018)。

摘　　要：目的 分析儿童脑膜瘤的CT和MRI影像表现,以提高对该病的诊断正确率。方法 回顾性分析14例经手术、病理证实的脑膜瘤的临床及影像资料,并复习相关文献。结果 14例患儿中男9例,女5例,年龄10个月~18岁,平均年龄98.35个月;肿块大小约16 mm×14 mm×15 mm~63 mm×79 mm×90 mm。9例行CT检查,14例均行MRI检查。肿瘤位于鞍区、鞍旁、松果体区、眼眶、侧脑室内、桥小脑角区各1例,大脑镰旁2例,1例沿脑膜、大脑镰弥漫多发,其他5例分别位于顶部、额部、颞部。13例单发,1例弥漫多发,其中2例合并神经纤维瘤病。WHOⅠ级7例,WHOⅡ级4例,WHOⅢ级3例。肿瘤实性部分CT呈等、稍高密度影;MRI表现为T_1WI、T_2WI以等信号为主,其中3例T_2WI呈稍低信号,DWI呈等、稍高信号,增强扫描明显强化且大部分不均匀。发病部位在颅内者大部分伴水肿带。影像诊断误诊率50%(7/14)。结论 儿童脑膜瘤较大,囊变多,高级别脑膜瘤发病率高,好发位置与成人不一样,虽易误诊,但影像表现具有一定的特异性,结合临床有助于提高该病的诊断准确性。Objective To analyze the CT and MR manifestations of meningioma in children, to improve the diagnostic accuracy of this disease. Methods Retrospectively analyzed the clinical and imaging data of 14 cases with meningioma confirmed by surgery and pathology, and reviewed relevant literatures. Results There were 9 males and 5 females, aged from 10 months to 18 years, with an average age of 98.35 months. The size of the mass was 16 mm×14 mm×15 mm~63 mm×79 mm×90 mm.9 cases underwent CT examination, and 14 cases underwent MR examination. The tumors located in the sellar area(1 case),parasellar area(1 case),pineal area(1 case),orbit(1 case),lateral ventricle(1 case),cerebellopontine area(1 case),parafalcine(2 cases),parietal-frontal-temporal region(5 cases),respectively, with diffuse and multiple distributing in meninges and cerebral falx in 1 case.13 cases with single lesion and 1 case with multiple lesions.2 cases were accompanied with neurofibromatosis. There were 7 cases of WHO grade Ⅰ,4 cases of WHO grade Ⅱ,and 3 cases of WHO grade Ⅲ. Solid part showed iso-density or slightly hyper-density on CT,iso-intensity mainly on T_1WI and T_2WI,and iso-or slightly hyperintensity on DWI. Lesions showed slightly hypo-intensity on T_2WI in 3 cases. Lesions showed obvious enhancement and most of them were heterogeneous. Most of the cases with intracranial lesions were accompanied by edema. Rate of misdiagnosis was 50%(7/14). Conclusion Meningiomas in children are large and most of them show cystic area. With high incidence of the high-grade meningioma and different distribution comparing with adults, meningiomas in children could be misdiagnosed easily. Combing with clinical information, some specific imaging manifestations can help improve the diagnostic accuracy of this disease.

关 键 词：脑膜瘤 磁共振成像 X线计算机 儿童 

分 类 号：R739.45[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44