多形性黄色瘤型星形细胞瘤影像学表现与临床病理对照

目的 探讨多形性黄色瘤型星形细胞瘤的影像表现与临床病理特点. 资料与方法 回顾分析21例脑多形性黄色瘤型星形细胞瘤的CT 、MR表现和临床病理特点. 结果 病变好发于脑实质表浅部位,单发,多位于颞叶;15例病变以囊性为主,其中10例为大囊小结节,5例大囊大结节;6例病变以实性为主.组织病理学检查,肿瘤细胞具有明显多形性,瘤细胞间见大量网状纤维及淋巴细胞浸润;出血、钙化少见.免疫组织化学示所有病例胶原纤维酸性蛋白表达阳性.临床上该病好发于儿童及青少年,多有癫痫发作. 结论 多形性黄色瘤型星形细胞瘤的影像学表现具有一定特征,病变表浅且单发,多呈囊性改变并伴有壁结节,结合应用影像诊断新技术(DWI、MRS及PET/CT)有助于提高诊断能力.     

MR imaging findings of benign and malignant circumscribed breast masses: part 1. Solid circumscribed masses

The purpose of our study was to review the magnetic resonance (MR) imaging findings and pathological characteristics of benign and malignant cystic circumscribed breast masses. This article reviews the MR imaging findings of cystic circumscribed breast masses. Intracystic papillomas typically show a single mural nodule with a washout enhancement pattern. Intracystic papillary carcinomas show multiple mural nodules or grow as a solid mass that obliterates the cystic space with a washout enhancement pattern. Despite the MR imaging findings, however, many circumscribed breast masses are impossible to differentiate without performing a biopsy.     

MR imaging findings of benign and malignant circumscribed breast masses: part 2. Cystic circumscribed masses

The purpose of our study was to review the magnetic resonance (MR) imaging findings and pathological characteristics of benign and malignant cystic circumscribed breast masses. This article reviews the MR imaging findings of cystic circumscribed breast masses. Intracystic papillomas typically show a single mural nodule with a washout enhancement pattern. Intracystic papillary carcinomas show multiple mural nodules or grow as a solid mass that obliterates the cystic space with a washout enhancement pattern. Despite the MR imaging findings, however, many circumscribed breast masses are impossible to differentiate without performing a biopsy.     

多房囊性肾细胞癌的CT分析

目的:探讨多房性囊性肾细胞癌的CT表现特点及诊断价值。方法:回顾性分析13例经手术病理证实的多房性囊性肾细胞癌患者的CT图像及相关临床资料。结果:病变位于右肾8例,左肾5例。病灶直径4~25cm,平均13cm。病灶由多个囊腔和分隔构成,5例伴附壁结节,2例见囊壁钙化,增强后囊壁、分隔和壁结节可有强化。结论:多房囊性肾细胞癌的CT表现有一定特征性。CT在多房性囊性肾细胞癌的诊断中具有重要作用,但在鉴别时仍有一定难度。     

Haemorrhagic hepatic cyst: a differential diagnosis of cystic tumour

A 63-year-old man was found on ultrasound examination to have a hepatic cystic mass with a mural nodule, which was mildly enhanced on contrast enhanced CT and MRI. At surgery, the cystic fluid was haemorrhagic and histological examination of the mural nodule demonstrated an organized haematoma. This case is of interest in that an apparent mural nodule was present in a non-neoplastic cyst. Haemorrhagic hepatic cyst with an organized haematoma should be included in the differential diagnosis of cystic neoplasms.     

Acinic cell carcinoma of the head and neck: radiologic-pathologic correlation

OBJECTIVE: To describe and correlate the imaging and pathologic findings of acinic cell carcinoma (ACC) in the head and neck. METHODS: We reviewed the radiologic findings of 12 patients with pathologically proven ACC in the head and neck. They were 6 males and 6 females (ages: 5-75 years, mean 36 years) who undergoing computed tomography (CT, n=9) and CT with magnetic resonance (MR) imaging (n=3). RESULTS: The lesions in the superficial lobe of the parotid gland were solid (n=7), cystic (n=1), and cystic mass with mural nodule (n=1) on CT. A parapharyngeal lesion was cystic mass with mural nodule, and a submandibular and a palate tumor were cystic lesions on CT. All solid masses in the parotid gland (n=7) included focal low-attenuating portions on CT, which were microcyst, hemorrhage, or necrosis on pathologic examination. We could not find intratumoral calcifications or metastatic lymphadenopathy on imaging and histologic studies in all 12 cases. Internal hemorrhage on the MR images was seen in a parapharyngeal and a parotid lesion. CONCLUSION: Although ACC appears to have nonspecific imaging findings, familiarity with some imaging features can be helpful for differential diagnosis of head and neck tumors.     

Benign pleomorphic adenoma with extensive cystic degeneration: unusual MR findings in two cases

Two cases of benign pleomorphic adenoma (PA) with extensive cystic degeneration are described. In both cases magnetic resonance (MR) imaging revealed entirely cystic tumors with an irregularity at the cyst wall. Some additional findings were observed: one case showed layering within the cyst contents caused by intratumoral hemorrhage, and the other had a small mural nodule at the cyst wall that showed very low intensity on both T1- and T2-weighted images and corresponded pathologically to the hyaline stroma. In both cases, preoperative diagnosis was difficult based on the MR findings alone. Benign PA should be included in the differential diagnosis of an entirely cystic parotid mass.     

囊性肾癌的超声与CT诊断及鉴别诊断

目的:探讨超声及CT对囊性肾癌的诊断价值。方法:回顾性分析经手术和病例证实的25例囊性肾癌的超声及CT表现。结果:依据各种不同的影像学表现将囊性肾癌分为:单房囊肿型,多房囊肿型,附隔、壁结节型和囊实混合型四类。其特点为:囊壁及囊内间隔局部不规则增厚或附有实性结节,以囊性为主的囊实性肿块;增厚的囊壁、间隔或附壁结节内可见强化。结论:超声及CT检查对囊性肾癌的诊断与鉴别诊断具有一定的临床实用价值。     

儿童期小脑星形胶质细胞瘤的MRI特征

目的　探讨小脑星形胶质细胞瘤的组织类型与MRI表现特征。方法　对 3 1例经病理证实的小脑星形胶质细胞瘤组织类型和MRI表现进行回顾性分析。结果　 3 1例小脑星形胶质细胞瘤中 ,3 0例 (96.8% )组织学证实为毛细胞型星形胶质细胞瘤 ;1例 (3 .2 % )为非毛细胞型星形胶质细胞瘤。MRI表现分为以下五型 :(1)假囊伴壁结节型 ,占 3 8.7% ;(2 )假囊型 ,占 16.1% ;(3 )囊性伴壁结节型 ,占 2 9% ;(4 )实质型 ,占 12 .9% ;(5 )移行型 ,占 3 .2 %。结论　毛细胞型星形胶质细胞瘤是儿童期小脑最常见的良性肿瘤 ,肿瘤在生长过程中可发生坏死和囊变 ,从实质型向其它各型演变。毛细胞型肿瘤血管为有孔型毛细血管 ,MRI增强可见肿瘤活性部分有明显强化     

Differential diagnosis of benign or malignant intraductal papillary mucinous neoplasm of the pancreas by multidetector row helical computed tomography: evaluation of predictive factors by logistic regression analysis

OBJECTIVE: The purpose of this study is to evaluate predictive factors for discriminating benign from malignant intraductal mucin-producing neoplasm (IPMN) of the pancreas on multidetector row computed tomography (MDCT). MATERIALS AND METHODS: Fifty-three patients with IPMN underwent MDCT, and the imaging and pathological findings were evaluated. In patients with branch duct-type tumors, sex and age of the patient, location, shape, size and multiplicity of the cystic lesion, presence of mural nodule, and maximum diameter of main pancreatic duct (MPD) dilatation were evaluated by logistic regression analysis. RESULTS: Tumors were classified as main duct-type (n = 7) and branch duct-type (n = 46). Among main duct-type tumors, all 7 lesions were diagnosed as malignant. Among 46 lesions of branch-type IPMN, 8 lesions were malignant, and 38 lesions were benign. On adjusted logistic regression analysis, combination factor of main duct dilatation and mural nodule or large cystic size had statistical significance for the risk of malignancy in branch duct-type IPMN. CONCLUSIONS: Main duct-type IPMN is highly suggestive for malignancy. Combination factors of main ductal dilation and mural nodule, and main ductal dilation, and large cystic tumor size are thought to be predictive factors for malignant branch-type IPMN.     

多房囊性肾癌的超声分析

目的分析多房囊性。肾癌的声像图表现,以提高对此病的认识及诊断率。方法13例多房囊性肾癌患者均行彩色多普勒血流显像（CDFI）和能量多普勒血流显像（PDI）检查,以及CT和（或）MRI动态增强扫描。结果多房囊性肾癌13例中,囊壁增厚或厚薄不均匀11例,囊壁菲薄均匀2例。其中伴壁结节或（和）隔结节10例,分隔厚薄不均匀8例、纤细均匀5例,分隔呈“车辐轮”状4例。3例病灶内可见囊壁和（或）分隔钙化。CDFI和（或）PDI在瘤体内检测到星点状或短条状血流信号10例,CT和（或）MRI增强扫描有不同程度增强11例。结论多房囊性肾癌多表现为多房囊性肿物,边界清楚,囊壁可有局部增厚,分隔粗细不均匀,附壁及分隔结节直径均小于6．0mm,CDFI和PDI能提高多房囊性肾癌的诊断率。本病需要与复杂性。肾囊肿及肾癌囊性变等鉴别诊断。     

Cystic mural nodule in cerebellar hemangioblastoma: CT demonstration

An example of a form of cystic hemangioblastoma of the cerebellum in which the mural nodule itself showed a central cystic area is presented. Although the precise etiology of the cystic component within hemangioblastoma tumor nodules is not known, it probably results from tumor degeneration. Computed tomography is valuable in identifying this feature, which, if present, is very suggestive of the diagnosis of hemangioblastoma. Other diagnostically useful CT features of hemangioblastoma that were present in this case included location of the mural nodule adjacent to the nearest pial surface, isodensity of the nodule on the preinfusion scan, and very rapid circulation of contrast material through the wall of the nodule, demonstrated by dynamic CT technique.     

颅内神经元及混合性神经元-神经胶质肿瘤的MRI诊断

目的:探讨颅内神经元及混合性神经元-神经胶质肿瘤的MRI表现特征,以提高对其认识和诊断水平。方法:复习22例经手术病理证实的神经元及混合性神经元-神经胶质肿瘤的临床和影像资料,结合文献分析其MRI表现特征。结果:5例中枢神经细胞瘤均位于侧脑室内,呈不均匀长T1、长T2信号和不均匀强化;1例神经节细胞瘤位于颞叶,呈长T1、长T2信号,无瘤周水肿和强化;12例神经节细胞胶质瘤中,6例在颞叶,5例为囊性并有强化壁结节;2例胚胎发育不良性神经上皮肿瘤均位于颞叶皮质,呈不均匀长T1、长T2信号,无瘤周水肿和强化;1例婴儿促纤维增生性神经节细胞胶质瘤位于颞叶皮质,为不均匀长T1和一致性长T2信号,无瘤周水肿,呈环状强化;1例乳头状胶质神经元肿瘤在颞叶,呈囊性并有不规则壁结节,其囊壁和壁结节发生强化。结论:MRI检查,不同类型的神经元及混合性神经元-神经胶质肿瘤各具其好发部位并多有一定表现特征,结合患者年龄和临床表现,常可做出倾向性诊断。     

颅内毛细胞星形细胞瘤的MRI诊断

目的 探讨毛细胞星形细胞瘤的MRI特点.资料与方法 回顾性分析经手术、病理证实的13例毛细胞星形细胞瘤的MRI表现,探讨肿瘤的部位、形态、信号等特点,并与病理诊断结果做对比.结果 13例毛细胞星形细胞瘤中,儿童及青少年8例;小脑蚓部5例,其他部位8例.MRI扫描:肿瘤完全囊变者1例,囊实性者9例,实性者3例,伴附壁结节者1例.T1WI上囊性部分呈低信号,实性部分呈等低信号,T2WI上囊性部分呈高信号,实性部分呈等高信号.增强扫描囊性部分不强化,实性部分及附壁结节呈明显强化.肿瘤DWI低信号11例,等低混杂样信号2例,SWI可见低信号2例.伴有轻度瘤周水肿及梗阻性脑积水各3例.结论 毛细胞星形细胞瘤好发于儿童及青少年,小脑蚓部多见,多为囊实性,占位效应较轻,MRI表现有一定的特征性.     

An autonomous functioning cystic thyroid adenoma. An unusual occurrence

An asymptomatic thyroid nodule that appeared cystic on ultrasound was seen in a 14-year-old girl. Tc-99m pertechnetate thyroid imaging was expected to show a cold nodule, but surprisingly revealed a hyperfunctioning nodule. A partial thyroidectomy revealed an hemorrhagic cystic adenoma. The occurrence of a cystic nodule, which continued to show hyperfunction, is unusual.     

Cystic intraductal papillary adenocarcinoma of the bile duct of the caudate lobe initially manifesting as a simple cyst on CT

Cystic-form, intraductal papillary neoplasms of the bile ducts (IPNBs) usually manifest as a multilocular cystic mass or unilocular cystic mass with papillary mural nodules. To our knowledge, cystic IPNBs forming single, unilocular cystic lesions without a visible papillary tumor and mimicking a simple hepatic cyst or mucinous cystadenoma have never been reported. Here, we report a case of cystic IPNB that initially appeared as a simple cyst and subsequently became a unilocular cystic mass with a papillary mural nodule on follow-up CT.     

胚胎发育不良性神经上皮瘤的MRI影像特点

目的 探讨胚胎发育不良性神经上皮瘤(DNT)的MRI成像特点.方法回顾性分析10例经手术后病理证实的DNT的MRI表现,总结肿瘤的特征性表现.结果 MR所见:6例表现为"大囊中结节"样,3例以囊性为主,囊内有分隔.肿瘤实性部分呈长T_1长T_2信号,囊性部分呈更长T_1长T_2信号,增强扫描表现为壁结节强化或囊内分隔轻度强化.瘤周水肿不明显,无明显占位效应.结论 DNT的MRI表现具有一定特征,结合其临床表现,可在术前做出正确的诊断.     

颅内血管母细胞瘤的低场MRI诊断

目的分析颅内血管母细胞瘤（ICHB）的特征性MRI表现并评价其诊断价值。方法24例经手术病理证实的ICHB患者于临床症状出现后均经头部MR平扫与增强扫描检查。全部MRI操作是采用PHILIPS GYROSCAN T5-NT0．5T超导性磁共振仪进行的。对所有患者的MRI表现进行了回顾性分析。ICHB按其MRI表现分为大囊小结节型、实质型和单纯囊型3种类型。结果MRI显示本组患者的ICHB多位于小脑半球,囊液呈长T1长T2信号,瘤结节规则,T1WI为稍低或等信号,T2WI为高信号,增强后呈明显均匀强化。24例中的5例被术前MRI误诊,其中,1例大囊小结节型被误诊为毛细胞型星形细胞瘤,2例实质型被误诊为髓母细胞瘤,以及2例单纯囊型被分别误诊为囊性星形细胞瘤和蛛网膜囊肿,而其余19例是由术前MRI明确诊断的,包括14例大囊小结节型和5例实质型,术前MRI对ICHB的诊断准确率为79．2％。结论多数ICHB具有特征性MRI表现,低场MRI对本病的定性诊断具有一定价值。     

3.0T MRI对胰腺囊性肿瘤的诊断价值

目的：探讨3.0T MRI对胰腺囊性肿瘤的诊断价值。方法：回顾性分析经手术病理证实的30例胰腺囊性肿瘤病例资料,总结其影像表现。结果：①黏液性囊性肿瘤15例,发生于胰腺体、尾部13例,肿瘤较大,平均直径85.0 mm,单囊和多囊各占7例,单囊者壁薄,小于1.5 mm,多囊者囊壁较厚,大于3.0 mm,囊壁持续强化,恶变3例,表现为强化的明显壁结节或不规则明显增厚间隔。②浆液性囊腺瘤9例,发生于胰头7例,平均直径45.0 mm,微囊型5例,3例表现为典型的放射状纤维间隔,大囊型2例,内呈网格状,所有病灶边缘清楚,T2WI均显示低信号间隔,轻度持续强化。③胰腺导管内乳头状瘤3例,均为老年患者,主导管型2例显示为扩张胰管并管内持续强化壁结节,分支型1例,表现为单发与胰管相通囊性灶,无壁结节。④胰腺假性囊实性乳头状瘤2例,均有出血;胰腺癌囊变1例,术前难以诊断。30例胰腺囊性肿瘤病灶均为囊性或囊实性,位于胰头部11例,胰体部9例,胰尾10例。结论：高场强MRI能更好地显示胰腺囊实性肿瘤的囊灶、囊壁、间隔以及实性部分各期的动态变化,结合不同病变的特点和临床,可对术前部分肿瘤定性诊断。     

囊性肾癌的CT诊断和鉴别诊断

目的:探讨囊性肾癌的CT表现特点,旨在提高诊断及鉴别诊断水平。方法:回顾性分析14例经手术病理证实的囊性肾癌CT影像学表现特点。结果:囊性肾癌14例中,单囊8例、多囊6例。囊壁增厚或厚薄不均11例,囊壁菲薄均匀3例。其中伴壁结节及分隔各4例、伴壁结节与分隔同时存在2例,分隔厚薄不均5例、纤细均匀1例。平扫肿瘤呈囊实性混杂密度12例、呈较均匀囊样低密度2例;囊液密度较高、隐约见碎屑、絮状物或明显出血9例,囊液均匀如水5例;肿瘤实性部分钙化3例。增强后肿瘤实性部分呈明显快进快退型强化11例,部分呈快进快退型强化合并部分中度进行性延迟强化1例,轻度强化2例。肾门或后腹膜淋巴结转移4例。结论:CT检查对囊性肾癌的诊断和鉴别诊断具有一定的临床实用价值。