颅内硬膜型海绵状血管瘤的影像学诊断

目的　分析颅内硬膜型海绵状血管瘤的影像学表现。方法　经手术病理证实的颅内硬膜型海绵状血管瘤２１ 例，位于中颅窝鞍旁的１８ 例，中颅窝外病灶３ 例。２０ 例行ＭＲＩ检查，９ 例行ＣＴ 扫描，１３ 例行ＤＳＡ 检查。结果　根据解剖部位、影像表现等特点将颅内硬膜型海绵状血管瘤分为中颅窝组和中颅窝外组。中颅窝硬膜型海绵状血管瘤表现为类哑铃形较均匀的稍长Ｔ１ 信号，在Ｔ２ ＷＩ和质子密度像为高信号，增强扫描多见明显均匀强化。ＤＳＡ多表现为毛细血管期至窦期的淡染色影。右顶镰旁及左额凸面病灶注射造影剂后明显强化。右ＣＰＡ（桥小脑角）病灶ＣＴ 表现为类圆形低密度团块，ＤＳＡ 见致密染色影。结论　中颅窝硬膜型海绵状血管瘤的ＭＲＩ和ＤＳＡ 表现比较有特异性，颅内中颅窝外硬膜型海绵状血管瘤的影像学表现无明显特异性。

Imaging Diagnosis of Intra-crainal Dural Cavernous Hemangioma

Purpose To find out CT,MRI,DSA features of inside and outside middle fossa dural cavernous hemangioma. Methods 21 cases intracranial dural cavernous hemangioma with pathology correlation were studied. 18 cases inside middle fossa, 3 cases outside middle fossa. 20 cases with MRI examination, 9 cases with CT imaging, 13 cases with DSA. Results Intracranial dural cavernous hemangioma could be divided into 2 groups: inside middle fossa and outside middle fossa according as anatomic position, imaging manifestation et al. Inside middle fossa dural cavernous hemangioma is always seen in middle aged women. The bulk is a dumbbell shaped lesion with homogenous slight hyperintensity on CT images, and homogenous slight hypointense on T\-1WI,hyperintense on T\-2WI and proton density images. After injecting contrast medium, the bulk markedly enhence. Faint stain from capillary stage to sinus stage always could be seen on DSA images. The right parietal parafalcine and left frontal convexity lesions get markedly enhance with contrast medium. One case in right CPA was hypointensity on CT with intense stain on DSA. Conclusion Inside middle fossa dural cavernous hemangioma prefers to be occurred in middle aged women and with specific MRI and DSA features. There are no specifie findings in outside middle fossa dural cavernous hemangioma on imaging.