少见单发颅内脑外肿瘤的影像征象分析及鉴别诊断

发布时间：2018-03-10 02:16

本文选题：颅内脑外肿瘤　切入点：软骨肉瘤　出处：《临床放射学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨少见单发颅内脑外肿瘤的影像表现及特征,旨在提高对该类疾病影像学特征的认识。方法搜集经手术病理证实的25例少见单发颅内脑外肿瘤患者完整影像和临床资料,回顾性分析其MRI及CT特点,所有患者均行MRI平扫和增强扫描,14例行CT平扫和增强扫描。结果 25例患者均为单发病灶,其中软骨肉瘤4例,均位于硬膜外颅底骨间的软骨结合处,CT平扫呈略低或等密度软组织肿块,其内可见大小不等高密度钙化,MRI平扫信号不均匀,T2WI呈不均匀高信号,增强扫描不均匀强化;血管外皮细胞瘤(HPC)7例,均呈分叶状肿块,6例病灶内或周围可见流空血管,3例跨硬脑膜生长;孤立性纤维性肿瘤(SFT)7例,6例可见"阴阳征",即增强扫描T2WI低信号区延迟期明显强化;脑外型海绵状血管瘤7例,5例跨鞍内外生长,呈"横葫芦征"表现,7例T2WI均表现为脑脊液样高信号。结论以上四种脑外肿瘤临床少见,容易误诊,但MRI表现均具有一定的特征性,仔细分析病变位置、形态、与血管及周围结构的关系及强化特点并结合CT表现有助于提高术前诊断的准确率。
[Abstract]:Objective to investigate the imaging features of rare solitary intracranial and extracranial tumors in order to improve the understanding of the imaging features of these diseases. Methods the complete images and clinical data of 25 patients with rare solitary intracranial extracerebral tumors proved by surgery and pathology were collected. The features of MRI and CT were retrospectively analyzed. All the patients were performed MRI plain scan and contrast-enhanced CT scan in 14 cases. Results all 25 cases were single focus, 4 cases were chondrosarcoma, 4 cases were chondrosarcoma, 4 cases were chondrosarcoma, and 4 cases were chondrosarcoma. All of them were located in the interosseous cartilage junction of the epidural skull base. The CT plain scan showed a soft tissue mass of slightly low or equal density, and the size of calcification was not equal. The MRI signal intensity was not even and the signal intensity was not even on T _ 2WI, and the enhancement was not uniform. In 7 cases of hemangiopericytoma, there were 6 cases with lobular mass and 3 cases with empty blood vessels in or around the lesion, while 7 cases with solitary fibrous tumor showed "yin and yang" sign, that is, the delayed phase of low signal area on T _ 2WI was obviously enhanced. In 7 cases of extracranial cavernous hemangioma, 5 cases grew across the Sella and 7 cases showed "transverse gourd sign" on T2WI, all of them showed cerebrospinal fluid hyperintense. Conclusion the above four kinds of extracerebral tumors are rare in clinic and easy to misdiagnose. However, all MRI findings have some characteristics. Careful analysis of the location, morphology, relationship with blood vessels and surrounding structures and enhancement features and CT findings can help to improve the accuracy of preoperative diagnosis.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【分类号】：R445.2;R739.4

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