小脑延髓池肿瘤的MRI诊断——定位与征象

发布时间：2018-08-18 09:45

【摘要】：目的探讨小脑延髓池肿瘤的MRI诊断价值。方法对17例经手术病理证实的小脑延髓池肿瘤的MRI表现进行回顾性分析。所有病例均采用3.0 T MR扫描仪平扫加增强扫描,并行横断位、矢状位、冠状位重组,分析肿瘤部位、与周围组织的关系及MRI特征。结果本组中神经鞘瘤4例,肿瘤贴附于延髓背侧呈偏侧性生长,囊变明显,增强囊壁及实性部分明显强化;室管膜瘤3例,肿瘤定位于小脑延髓池,形态不规则并有囊变,可见脑脊液环绕,增强实性部分轻至中度强化;脑膜瘤3例,均为宽基底的实性肿块,增强均匀明显强化,其中1例见"脑膜尾征";血管母细胞瘤3例,2例表现为"大囊小结节";1例瘤体为实性肿块,增强后明显强化,瘤周可见粗大供血动脉;脉络丛乳头状瘤2例,为小脑延髓池内浅分叶状的肿块,周围见脑脊液环绕,信号稍不均匀,增强均见明显强化,1例见微囊变;胶质母细胞瘤1例,肿瘤来源于小脑半球并突向小脑延髓池,信号不均匀,见多发囊变及周围脑组织水肿,增强后呈"花环"状强化;脂肪瘤1例,T1WI、T2WI均呈高信号,脂肪抑制呈低信号,边界清晰,增强扫描强化不明显。结论小脑延髓池肿瘤的MRI表现各有其特点,通过MRI检查能精确定位,有助于推断肿瘤的来源,并根据信号特点进行定性诊断。
[Abstract]:Objective to investigate the value of MRI in the diagnosis of cerebellar medullary cistern tumors. Methods MRI findings of 17 cases of cerebellar medullary cistern tumors confirmed by operation and pathology were retrospectively analyzed. All cases were examined with 3. 0T Mr scan with plain scan and enhanced scan, and then were reconstructed in transverse, sagittal and coronal position. The relationship between tumor location and surrounding tissues and MRI features were analyzed. Results in 4 cases of neurilemmoma, the tumor was attached to the dorsal side of the medulla oblongata, with obvious cystic change, enhanced cystic wall and solid enhancement, and ependymoma in 3 cases, the tumor was located in the medullary cistern of cerebellum oblongata with irregular morphology and cystic degeneration. All cases of meningioma were solid masses with wide base, and the enhancement was even and obvious, and the enhancement was moderate to moderate in the surrounding cerebrospinal fluid (CSF), 3 cases of meningioma were all solid masses with a wide base, and the enhancement was even and obvious. "meningeal tail sign" was seen in 1 case, hemangioblastoma in 2 cases presented as "big cystic nodule" (1 case) as solid mass, enhanced obviously after enhancement, and large supply artery around the tumor, choroidal plexus papilloma (2 cases), and choroidal plexus papilloma (2 cases). It was a superficial lobular mass in the cerebellar medullary cistern, surrounded by cerebrospinal fluid (CSF), slightly uneven in signal intensity, obviously enhanced in 1 case, microencapsulated in 1 case, glioblastoma in 1 case, the tumor originated from the cerebellar hemisphere and protruded to the cerebellar medulla cistern. The signal intensity was not uniform, multiple cystic changes and edema of peripheral brain tissue were observed, and enhanced with "rosette" enhancement, 1 case of lipoma showed high signal intensity on T _ 1WI ~ (I) T _ 2WI, low signal intensity on fat suppression, clear boundary, and no obvious enhancement on enhanced scan. Conclusion the MRI findings of cerebellar medullary cistern tumors have their own characteristics. The accurate location of the tumors can be determined by MRI, which is helpful to infer the origin of tumors and to make qualitative diagnosis according to the signal characteristics.
【作者单位】：福建省龙岩市第二医院放射科;中山大学附属第一医院放射科;
【分类号】：R739.41;R445.2

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