颅咽管瘤非典型MRI表现

目的探讨颅咽管瘤非典型MRI表现,以提高对此病的认识。方法回顾性分析4例经手术病理证实的颅咽管瘤的MRI资料。结果4例肿瘤均为囊性:例1肿瘤位于鞍上,瘤内可见脂液平面,脑室、脑池及脑沟内可见大小不等的脂肪小滴;例2肿瘤的大部分位于桥小脑角区,仅小部分位于鞍上,T1WI和T2WI均为高信号,脂肪抑制亦为高信号;例3肿瘤位于鞍上,突向鞍内并延伸至胼胝体压部下方,蝶鞍稍增大,垂体未显示,T1WI和T2WI均为高信号;例4肿瘤位于鞍内及鞍上,蝶鞍扩大,垂体未显示,肿瘤前部T1WI和T2WI均为高信号,后部T1WI信号稍高,T2WI与白质信号相同。结论颅咽管瘤存在方式多种多样,有特征性的MRI表现,也可有非典型MRI表现,肿瘤可向邻近部位延伸,亦可破裂播散至蛛网膜下腔内。囊性颅咽管瘤的信号特点与囊液的成分有关。

The MRI manifestation of craniopharyngiomas

Objective To investigate the atypical MRI manifestations of craniopharyngioma and understand this disease further. Methods 4 cases of craniopharyngiomas with MRI manifestation confirmed by operation and pathology,were analyzed retrospectively. Results 4 cases were all cystic tumor. The tumor of case 1 was located in suprasellar region,which had lipid-liquid boundary in the focus,and there were many lipid droplets in cerebral ventricle,sulcus and cistern. The tumor of case 2 showed high signal on T_1WI,T_2WI,and fat-suppression image,most of which was in cerebello pontine angle and only a small part in suprasellar region. The tumor of case 3 accompanied with slightly enlarged sella turcica and invisible pituitary gland,was located in suprasellar region and extended to splenium of corpus callous,which manifested high signal on T_1WI and T_2WI. The tumor of case 4 was in sella turcica and protruded to suprasellar region,the anterior of which showed high signal on T_1WI and T_2WI,while the posterior of the mass manifested little high signal on T_1WI and the same signal as the white matter on T_2WI. Conclusion There are diverse MRI manifestations of craniopharyngioma,specific or non-specific. The tumor can extend to other spots nearby or disrupt into subarachnoid space. MRI signal specialty of cystic craniopharyngioma is related to the contents of the cystic fluid.