12例中枢神经系统原发恶性黑色素瘤的影像学表现

发布时间：2018-05-04 05:50

本文选题：中枢神经系统 + 原发恶性黑色素瘤　；参考：《重庆医学》2017年32期

【摘要】：目的探讨中枢神经系统(CNS)原发恶性黑色素瘤的CT及MRI表现。方法回顾性分析经手术病理及免疫组织化学证实的12例CNS原发恶性黑色素瘤患者的临床及影像学资料(12例均行CT平扫,7例行CT增强,其中5例行MRI平扫及增强)。结果 12例患者均为单侧,CT平扫主要表现为软组织密度,CT值46~62HU,肿瘤形态多样,其内未见囊变、钙化,1例累及前床突,增强后明显不均匀强化。5例MRI平扫示,形态呈团块状、分叶状,1例典型表现为T1WI高信号、T2WI低信号,4例呈非典型性改变,2例表现为以T1WI等信号、T2WI低信号为主,2例表现为以T1WI等信号、T2WI稍高信号为主,4例均有局部囊变及点、片状出血灶,增强后强化方式多样,1例累及胸椎及附件。结论 CNS原发恶性黑色素瘤具有典型的影像学表现,尤其是具有特征性MRI信号特点,但罕见,CT结合MRI检查有助于其诊断及鉴别诊断。
[Abstract]:Objective to investigate the CT and MRI findings of primary malignant melanoma of central nervous system (CNS). Methods the clinical and imaging data of 12 patients with primary malignant melanoma of CNS confirmed by operation, pathology and immunohistochemistry were retrospectively analyzed. All 12 cases underwent plain CT scan in 7 cases, and 5 cases with MRI plain scan and enhancement. Results all the 12 patients showed unilateral CT plain scan with soft tissue density and CT value of 4662HU.There were a variety of tumors with no cystic changes in them, and calcification occurred in 1 case involving the anterior clinoid process. After enhancement, MRI plain scan showed obvious uneven enhancement in 5 cases. One case of lobulated fistule was characterized by high signal intensity of T1WI and low signal intensity on T _ 2WI. 2 cases were characterized by T1WI isointense signal intensity and T _ 2WI low signal intensity. 2 cases showed that 4 cases had local cystic change and focal point on T1WI isointense T _ 2WI, and 4 cases had local cystic lesions and focal spots on T _ 2WI. One case involved thoracic vertebrae and appendages in various ways after enhancement. Conclusion CNS primary malignant melanoma has typical imaging features, especially characteristic MRI signal, but rare CT combined with MRI is helpful for its diagnosis and differential diagnosis.
【作者单位】：昆明医科大学第一附属医院医学影像中心;
【分类号】：R445.2;R730.44;R739.4

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