室管膜下巨细胞星形细胞瘤的MRI诊断VIP专享VIP免费

作者单位:100050首都医科大学北京市神经外科研究所神经影像中心(韩建成、高培毅、林燕、徐磊、田同德),神经外科(杨智君);*首都医科大学2004级硕士研究生ü中枢神经放射学þ室管膜下巨细胞星形细胞瘤的MRI诊断韩建成*,高培毅,林燕,徐磊,田同德,杨智君=摘要>目的研究室管膜下巨细胞星形细胞瘤(SGCA)的MRI表现,探讨MRI对该病的诊断价值。资料与方法回顾性分析经手术病理证实的9例SGCA的临床资料和MRI表现,其中男4例,女5例,年龄4~23岁,平均12.9岁。全部病例术前均行MRI平扫和增强检查。结果所有肿瘤均位于侧脑室孟氏孔附近,3例呈类圆形,6例呈轻度分叶状。平扫T1WI为等或稍低信号,T2WI为等或稍高信号,9例均可见肿瘤周边点状或结节状钙化信号,2例肿瘤内部可见长T1、长T2小囊状信号;增强扫描,肿瘤呈明显均匀或不均匀强化。7例可见室管膜下结节,3例可见皮质结节。结论SGCA的MRI表现有一定特征性,有助于术前诊断。=关键词>室管膜下巨细胞星形细胞瘤脑肿瘤磁共振成像MRIDiagnosisofSubepengdymalGiantCellAstrocytomaHANJiancheng,GAOPeiyi,LINYan,etal.NeuroimagingCenter,BeijingNeurosurgicalInstitute,TheCapitalUniversityofMedicalScience,Beijing100050,P.R.China=Abstract>ObjectiveTostudyMRIfindingsofsubependymalgiantcellastrocytomaandevaluateitsdiagnosticvalueinsubependymalgiantcellastrocytoma.MaterialsandMethodsClinicaldataandMRIfindingsin9patientsofsubependymalg-iantcellastrocytoma(4maleand5female;ranginginagefrom4to23yearsold;meanage:12.9years)withpathologicallyprovedwereretrospectivelyanalyzed.PreandpostMRscanswereperformedinallpatients.ResultsAlltumorswerelocatedneartheforamenofmonro,3patientswereroundlikeand6patientswereslightlylobulatedinshape.ThetumorswereappearedisoorhypointensityonT1WIandisoorhyperintensityonT2WI,therewerepunctateornodularcalcificationsintheborderofthetumorsinallcases,andsmallcysticchangesinthecenterofthetumorsin2patients.Afterinjectionofcontrastagent,thetumorsweremarkedlyhomogeneousorheterogeneousenhancement.Subependymalnoduleswereseenin7patients,andcorticaltuberswereobservedin3patients.ConclusionTheMRIfindingsofsubependymalgiantcellastrocytomaarecharacteristic,whichplayanveryimportantroleinmakingacorrectpreoperativediagnosis.=Keywords>SubependymalgiantcellastrocytomaBraintumorMagneticresonanceimaging室管膜下巨细胞星形细胞瘤(subependymalgiantcellastrocytoma,SGCA)是一种伴发于结节性硬化(tuberoussclerosis,TS)的少见的中枢神经系统良性肿瘤,其发生率占所有TS患者的5%~14.3%[1,2]。在WHO2000年中枢神经系统肿瘤组织学类型中,其被归属于神经上皮肿瘤中的星形细胞肿瘤。临床表现多为颅内压增高的症状和体征[1~3]。MRI对本病具有重要的诊断价值。笔者回顾性分析经手术病理证实的SGCA患者9例,并结合相关文献,对SG-CA的MRI表现予以分析,旨在提高对该病的认识。1资料与方法搜集本院2001至2005经手术病理证实的SGCA患者9例,男4例,女5例,年龄4~23岁,平均12.9岁。临床表现为头痛、恶心、呕吐5例,发作性意识丧失2例,间断抽搐2例,视力下降3例。体检发现视乳头不清、水肿或萎缩者6例,双侧面部多发结节、腰背部多发结节1例,体检阴性者1例,左侧鼻唇沟略浅者1例。B超发现肝或肾多发占位者4例。9例术后病理证实均为SGCA。使用GESigna3.0T超导磁共振成像仪,采用液体衰减反转恢复技术(FLAIR)和快速自旋回波#598#临床放射学杂志2006年第25卷第7期(FSE)序列。T1WI:TR2247.89ms,TE19.70ms,TI860ms;T2WI:TR5000ms,TE116.61ms,层厚5mm,间隔1mm。SiemensMagnetomTrio3.0T超导磁共振成像仪,快速反转恢复(TIR)序列和快速自旋回波(TSE)序列。T1WI:TR1680ms,TE11ms;T2WI:TR6980ms,TE103ms,层厚5mm,间隔1.5mm。Tosh-iba1.5T超导磁共振成像仪,自旋回波(SE)和FSE序列,层厚、层距均为5mm。增强扫描对比剂为北陆公司磁显葡胺,注入剂量为0.2ml/kg体重,流率1ml/s,经肘静脉快速注入后,...