儿童颅内毛细胞型星形细胞瘤的误诊原因分析

发布时间：2018-02-28 13:33

本文关键词： 毛细胞型星形细胞瘤儿童磁共振成像体层摄影术 X线计算机　出处：《临床放射学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨儿童颅内毛细胞型星形细胞瘤(PA)的影像学诊断及分析误诊原因。方法回顾性分析36例经手术病理证实为PA而术前误诊为其他肿瘤的病例,男性23例,女13例,分析其CT和MRI表现,总结误诊原因。结果36例PA中,14例位于小脑,7例位于鞍区,6例位于大脑,5例位于脑干,3例位于松果体区,1例多发病灶。其中5例(13.9%)见肿瘤内钙化,3例(8.3%)见肿瘤内出血,21例(58.3%)表现为各种不典型强化,2例(5.6%)出现脑脊液播散。11例的Cho/NAA平均值为2.53±0.94,其中9例Cho/NAA比值2,4例可见Lac峰。本组35例(97.2%)DWI呈等、低信号。结论肿瘤内钙化、出血,不典型强化方式,软脑膜播散,多发病灶以及与恶性肿瘤相似的MRS表现是PA的误诊原因。DWI呈等或低信号,肿瘤边界清楚,无或轻度瘤周水肿则支持PA的诊断。
[Abstract]:Objective to investigate the imaging diagnosis and causes of misdiagnosis of intracranial hair cell astrocytoma (PAA) in children. Methods 36 cases of PA proved by operation and pathology were misdiagnosed as other tumors before operation, including 23 males and 13 females. Ct and MRI findings were analyzed. Results of 36 cases of PA, 14 cases were located in cerebellum, 7 cases were located in Sellar region, 6 cases were located in brain stem, 3 cases were located in pineal region, 1 case was multiple lesions, 5 cases were located in pineal region. The mean value of Cho/NAA was 2.53 卤0.94 in 11 cases, and Lac peak was seen in 24 cases in 9 cases. Conclusion calcification, hemorrhage, atypical enhancement mode, spread of pial meninges, multiple lesions and MRS findings similar to malignant tumors are the causes of misdiagnosis of PA. No or mild peritumoral edema supported the diagnosis of PA.
【作者单位】：浙江大学医学院附属第一医院放射科;上海交通大学医学院附属新华医院;
【分类号】：R739.4;R445.2;R730.44

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