颅内多形性黄色星形细胞瘤的MRI表现及误诊分析

发布时间：2018-06-20 05:05

本文选题：星形细胞瘤 + 磁共振成像　；参考：《中国医学影像技术》2015年02期

【摘要】：目的探讨颅内多形性黄色星形细胞瘤的MRI特点并分析误诊原因。方法回顾性分析12例经病理证实的颅内PXA的临床、病理及影像学资料。结果肿瘤均位于幕上,9例部位表浅,与脑膜关系密切,但仅3例见脑膜强化。瘤体呈多房囊性伴壁结节8例,呈实性伴囊变4例。实性成分与正常脑灰质信号相比,T1WI呈等或稍低信号,T2WI呈等或稍高信号;囊性成分与脑脊液相比,FLAIR呈稍高信号。FLAIR示11例轻-中度瘤周血管源性水肿。7例接受DWI,实性部分6例呈等或稍高信号,1例呈明显高信号。3例接受MRS检查,瘤体实性部分胆碱/肌酐(Cho/Cr)升高,N-乙酰天门冬氨酸/肌酐(NAA/Cr)降低,1例见脂质(lip)峰。增强后瘤体实性部分明显强化,其中不均匀强化7例,均匀强化5例。8例术前误诊,分别诊断为胚胎发育不良性神经上皮肿瘤(2例)、脑膜瘤(1例)、间变性星形细胞瘤(1例)、血管母细胞瘤(1例)、节细胞胶质瘤(2例)、脉络丛乳头状瘤(1例)。结论 PXA临床罕见,与胚胎发育不良性神经上皮肿瘤、脑膜瘤等影像表现相似,术前易误诊,结合MR功能成像有助于鉴别诊断。
[Abstract]:Objective to investigate the MRI features of intracranial pleomorphic xanthomatous astrocytoma and to analyze the causes of misdiagnosis. Methods the clinical, pathological and imaging data of 12 patients with pathologically proved intracranial PXA were retrospectively analyzed. Results all tumors were superficial in 9 cases and had close relationship with meninges, but only 3 cases showed meningeal enhancement. The tumors were multilocular cystic with wall nodule in 8 cases and solid with cystic degeneration in 4 cases. Compared with normal gray matter, the solid components showed iso-or slightly low signal intensity on T _ 1WI and isointense or slightly high signal intensity on T _ 2WI. Compared with cerebrospinal fluid (CSF), saccular flair showed slightly higher signal intensity. Flair showed that 11 patients with mild to moderate peritumoral vasogenic edema received DWI, while 6 patients with solid part showed equal or slightly hyperintense signal intensity. 3 patients received Mrs examination. Solid partial choline / creatinine Cho / Cr increased N- acetyl aspartate / creatinine NAA / Cr decreased in 1 case with lipid lipase peak. There were 7 cases of uneven enhancement and 5 cases of homogeneous enhancement before misdiagnosis. Two cases of neuroepithelial tumors with dysembryogenesis, 1 case of meningioma, 1 case of anaplastic astrocytoma, 1 case of hemangioblastoma, 2 cases of ganglioma and 1 case of choroid plexus papilloma were diagnosed. Conclusion PXA is rare in clinic and similar to neuroepithelial tumors and meningiomas in embryonic dysplasia. It is easy to be misdiagnosed before operation. Mr functional imaging is helpful in differential diagnosis.
【作者单位】：南方医科大学南方医院影像中心;南方医科大学南方医院病理科;
【分类号】：R739.41;R445.2

【相似文献】