脑星形细胞瘤肿瘤出血的MRI诊断与鉴别诊断

目的探讨脑星形细胞瘤肿瘤出血的MRI表现特点及其与脑内非肿瘤性出血的鉴别诊断。方法经外科手术病理证实的脑星形细胞瘤肿瘤出血15例,全部行MRI平扫和增强扫描。结果脑星形细胞瘤肿瘤征象与出血征象并存12例,表现为灶样出血型;未见明确肿瘤征象而只表现为出血征象3例,包括结节肿块型2例、环型1例。脑星形细胞瘤肿瘤出血的信号T1WI为点状、结节肿块样或环型高信号;T2WI高信号为主,高信号内或周围可有略高信号,内部信号多不均匀。增强扫描出血灶呈不同程度和形态的强化。结论MRI平扫和增强扫描能显示脑星形细胞瘤肿瘤出血的形态及信号特点,有助于脑星形细胞瘤肿瘤出血与脑内非肿瘤性出血鉴别。

MRI diagnosis and differential diagnosis of hemorrhagic intracerebral astrocytoma

Objective To study the MRI features of bleeding intracerebral astrocytomas and the differential diagnosis of neoplastic and non-neoplastic hematomas.Methods Fifteen patients with hemorrhagic intracerebral astrocytomas diagnosed by pathology were investigated.All the patients underwent MRI imaging and enhanced MRI.Results Tumor and hemorrhage signs were shown in 12 patients with focal hemorrhage type.Only hemorrhage sign was shown in 3,including nodular(n=2) and ring like (n=1) hemorrhage types.Hematomas were focal,nodular or ring like high signal on T1WI,while T2WI was high signal mainly.The signs of hemorvhage focas of different tyge tumors were enhanced in varying degrees and shapes after intravenous Gd-DTPA enhancement.Conclusion MRI is helpful to differentiate hemorrhagic intracerebral astrocytoma from non-neoplastic hematoma.