中枢神经细胞瘤的MRI诊断

目的 探讨中枢神经细胞瘤(CNC)的MRI表现特征.方法 南方医科大学珠江医院自2007年1月至2010年1月行手术治疗CNC患者13例,术前均行MRI平扫及增强扫描,其中1例并行术前CT平扫及增强扫描.总结分析患者的临床、MRI资料及病理表现.结果 肿瘤最大径约3.2～8.5 cm,12例CNC位于侧脑室内孟氏孔区,1例位于左颞顶叶脑实质内,均表现为分叶状的实体瘤,平扫以等T1、稍长T2信号为主,信号不均匀,可见多发、散在分布的小囊变区,表现为更长T1、更长T2信号;6例T2WI上可见流空血管影;8例见斑点状稍短T1信号;增强扫描肿瘤呈不均匀显著强化,6例可见强化肿瘤血管;病理表现为灶性钙化,可见典型无细胞纤维岛.结论 脑室内CNC具有特征性的发病部位,结合患者发病年龄、MRI平扫及增强扫描表现多可做出正确诊断;脑室外CNC定性诊断较困难.

Abstract：

Objective To evaluate the MRI features of central neurocytoma (CNC). Methods Thirteen patients with CNC (7 males and 6 females, aged 18-28), admitted to our hospital fiom January 2007 to January 2010, were chosen; preoperative plain and contrast enhanced MRI scans were performed on these 13 patients and 1 also received CT scan. The clinical and imaging data and pathological features of these patients were retrospectively analyzed. Results The largest tumor enjoyed its maximum diameter of 3.2-8.5 cm; the CNC in 12 patients located at the lateral ventricle and that in 1 patient at the parenchyma of the left frontal and temporal lobes. Lobulated solid tumors were noted in these lesions,showing T1 isointense and T2 hyperintense in MRI; some multiple, scattered cystic lesions showed stronger T1 and T2 signal than the former ones; vascular "flow void" signal was shown in 6 patients in T2WI, and slightly weak T1 signal was shown in 8. All the tumors demonstrated inhomogeneous enhancement and the tumor vessels in 6 patients were noted under contrast MRI. Focal calcification was found. Conclusion CNC in the lateral ventricle enjoys typical location; considering the age of patients, non-contrast and contrast MRI findings, correct diagnosis of CNC can be made; however, CNC outside the lateral ventricle is hard to diagnose.     

中枢神经细胞瘤94例临床分析

目的 总结中枢神经细胞瘤临床特点,探讨其治疗策略.方法 回顾性分析94例中枢神经细胞瘤患者临床资料.全部行手术治疗,肿瘤全切除66例,近全切除26例,部分切除2例;分析总结中枢神经细胞瘤的临床、病理、影像特点.结果 死亡2例,随访84例,术后放疗56例,肿瘤复发4例.多数患者生存良好.结论 中枢神经细胞瘤多发于室间孔附近侧脑室系统,手术全切除是最佳治疗手段,未全切患者术后放疗可减少复发率.

Abstract：

Objective To analyze the clinical characteristics of central neurocytomas,and discuss the therapeutic strategies.Methods 94 cases of central neurocytomas were studied retrospectively.All patients underwent operation with removal of the tumor through either transcallosal or transcortical approach.Total resection was achieved in 66 patients,subtotal resection in 26 patients and partial resection in 2 patients.The clinical,radiological,histologic and immunohistochemical features of these patients were reviewed and analyzed.Methods Amongthe 94 cases of central neurocytomas,two died after surgery.Among the 84 followed- up cases,56 cases underwent postoperative radiotherapy,4 cases had recurrence.Most patients have favorable prognosis.Conclusion Central neurocytomas occur mostly in the lateral ventricle near the Monro's foramen.Total resection is the best treatment.Postoperative radiotherapy for partially removed tumors may reduce the possibility of recurrence.     

中枢神经细胞瘤

中枢神经细胞瘤是近年来通过电镜和免疫组织化学检查识别出来的一种少见的肿瘤,其组织病理学特征为肿瘤细胞是由具有神经元分化特征的单一细胞群组成,肿瘤大多数为良性。最佳治疗方法是手术全切除或次全切除加放射治疗,多数愈后良好。本文通过复习文献介绍其病理及临床特点。     

中枢神经细胞瘤诊断及治疗

中枢神经细胞瘤（central nerve cell tumor,CNC）由Hassoun等1982年先对其进行报道并命名[1],1993年WHO中神经系统肿瘤组织学分类正式确定为独立的一类肿瘤,并归入神经元和混合神经元-胶质细胞肿瘤一类。2007年WHO中枢神经系统肿瘤分类将CNC描述为原纤维区域类似神经神经纤维网的肿瘤组织,病理级别为WHOⅡ级[2]。CNC是一种相对少见的中枢神经系统肿瘤,约占脑原发性肿瘤的0.25%~0.5%,多发于青壮年[3,4]。     

中枢神经细胞瘤的诊断和治疗

目的深入认识中枢神经细胞瘤,以期提高本病的诊疗水平。方法回顾性总结我科22例中枢神经细胞瘤的临床表现、影像学检查、诊断及治疗效果。结果所有22例均手术治疗,术后11例全切除病例中4例联合放射治疗,8例次全切除病例中3例联合放射治疗、1例化疗,3例部分切除病例中1例联合放射治疗、1例化疗。死亡7例,失访6例,其余9例随访2个月至35年,均未见肿瘤复发或再长。结论脑室内中枢神经细胞瘤手术风险较大,死亡率较高;运用显微神经外科及术中导航技术切除肿瘤可有效降低致残率和死亡率;联合术后放疗可减少本病复发;化疗的疗效有待评价。     

脑室内中枢神经细胞瘤诊治分析简

目的探讨脑室内中枢神经细胞瘤（ICN）的诊断及手术治疗效果。方法回顾性分析我科手术治疗并经病理学确诊的9例ICN患者的临床资料。结果肿瘤全切除6例,次全切除3例。无手术死亡病例。1例术前放疗肿瘤体积明显缩小,4例术后辅助放疗。所有患者术后随访3～44月,平均18．7月;2例复发,行γ刀切除;2例并发脑积水行脑室一腹腔分流术;其余患者恢复良好,无肿瘤复发或进展。结论ICN多以慢性颅内高压症状起病,缺乏局灶性神经系统缺损症状,但大多ICN术前根据特征性影像学表现可获得诊断。手术应作为治疗的首选方法,并力争在安全前提下全切除,可获得良好预后。     

中枢神经细胞瘤的诊断和治疗

目的探讨中枢神经细胞瘤的诊断和治疗。方法回顾性分析1992年12月至2005年12月我科收治的7例中枢神经细胞瘤病人的临床资料。结果本组7例中枢神经细胞瘤中,4例位于左侧脑室,2例位于右侧脑室,1例位于胼胝体;5例全切,1例次全切,1例部分切除,术后辅以放疗。随访无复发。结论中枢神经细胞瘤手术后辅以放疗可获得良好的预后。     

中枢神经细胞瘤的诊断和治疗

目的探讨中枢神经细胞瘤的临床特点、诊断及治疗方法。方法回顾性分析12例中枢神经细胞瘤患者的临床资料,所有患者均行手术治疗。结果12例中枢神经细胞瘤患者,肿瘤全切除9例,次全切除2例,大部分切除1例。所有患者术后随访3个月至lO年,l例术后1年复查示脑积水,行脑室一腹腔分流术;按GOS评分,12例均恢复良好。结论中枢神经细胞瘤显微手术切除术后辅以放疗可获得良好的治疗效果。     

中枢神经细胞瘤的鉴别诊断和治疗分析

目的 探讨中枢神经细胞瘤的临床特征、诊断要点以及手术疗效,加强认识,避免误诊.方法 报告2004-02～2009-02应用显微外科手术确诊和治疗的5例中枢神经细胞瘤.3例经额叶侧脑室入路,2例经胼胝体入路;病理确诊后均接受放射治疗.结果 3例肿瘤全切除,2例次全切除.术后随访1年3个月～5年,1例患者视力为眼前30cm手动,其余病人均恢复良好,未见肿瘤复发.结论 中枢神经细胞瘤是一种良性肿瘤,显微手术全切肿瘤可完全治愈,无需放疗;但对复发病例或肿瘤残留及组织病理学有恶性改变者,预后较差,往往需要放疗或化疗.     

中枢神经细胞瘤的影像学分析

目的 研究中枢神经细胞瘤（CNC）的影像学特点。方法 回顾性分析5例经手术病理证实为CNC的影像学资料。结果 肿瘤均位于透明隔及侧脑室，CT表现为等或稍高密度肿块，多见钙化。MRI表现为T1WI及T2WI均为与皮层灰质相等或略高信号，边缘清楚，体积较大，边缘及内部可见多发囊泡，增强后肿瘤轻、中度强化。结论 CNC主要发生在透明隔及侧脑室，其影像学表现有一定特征性，当此区发生肿瘤时，要考虑CNC的可能。     

脑室内中央性神经细胞瘤的诊断与治疗

目的　探讨中央性神经细胞瘤 (CN)的诊断、治疗及预后。方法　回顾分析我科 1 993～ 2 0 0 0年收治的1 7例CN的临床资料。结果　 1 7例患者发病年龄从 1 7到 47岁不等 ,平均 31 5岁。男女比例为 1 1 3∶1。颅内压增高是本病的主要临床表现。 1 6例行开颅手术 ,其中 4例全切除 ,7例次全切除 ,5例大部分切除。 7例于术后辅以放疗。另 1例于立体定向穿刺活检后行γ 刀治疗。 1 2例随访 6～ 77个月 ,平均 2 8 4个月。 1例行大部分切除而未接受放疗者于术后 8个月因肿瘤复发而死亡 ,其余 1 1例均未见复发。结论　CN通常被认为是一种分化程度较高的良性肿瘤 ,多数病例经手术切除后预后较好 ,对于手术未能全切除、术后有复发或经组织病理学证实有较高增殖活性的病例 ,可行放射治疗     

中枢神经细胞瘤研究进展

中枢神经细胞瘤是一种少见的神经元来源的脑室内肿瘤，大多呈良性，预后良好。其组织学病理特征为肿瘤细胞来源相同、体积小、大小一致、排列紧密。磁共振波谱特征包括胆碱增高、肌酸和N-乙酰天门冬酸盐减少。最佳的治疗方法是手术治疗，术后辅助放疗、化疗可以提高局部控制率或患者的生存率以及降低复发率。MIB-1标记指数在提示预后上价值较大。本文就近年来其影像、病理和临床等方面的研究进展做一综述。     

Update on the diagnosis,pathogenesis, and treatment strategies for central neurocytoma

Central neurocytomas are rare benign tumors of the central nervous system that are typically located in the lateral ventricles. Since they were first reported in the early 1980s, many advancements have been made in terms of their diagnosis and treatment. Despite the progress made, the origin of these rare tumors and effective newer treatment strategies remain elusive. Central neurocytomas represent 0.1–0.5% of all primary brain tumors. Since they are typically intraventricular, these tumors tend to present clinically with hydrocephalus. CT scanning and MRI are useful in localizing these tumors; however, due to their numerous ambiguous features, the ultimate diagnosis relies on immunohistochemistry and electron microscopy studies of sampled tissue. Currently, surgical removal with a gross-total resection of these tumors is the treatment of choice. Various radiotherapy techniques, including both conventional radiotherapy and stereotactic radiosurgery, have been shown to be useful in cases of residual tumor after sub-total resection and tumor recurrence. The benign nature of these tumors tends to offer a favorable outcome for most patients; however, recurrence rates are relatively high and tumors with high-grade features or extraventricular location tend to have a less favorable prognosis. We present a comprehensive review of these rare tumors, including their epidemiology, clinical presentation, radiological presentation, histopathological findings, and options for intervention including surgery, radiation therapy, stereotactic radiosurgery, and chemotherapy.     

中枢神经细胞瘤的诊断和显微手术治疗

目的探讨中枢神经细胞瘤的诊断和治疗经验。方法回顾性分析1995年8月～2003年7月我院收治的12例中枢神经细胞瘤，总结其临床表现、诊断方法及显微外科手术效果，结果手术治疗12例，其中9例完全切除．3例大部分切除，手术后常规进行放射治疗，随访6～24个月，效果良好。结论显微手术切除肿瘤辅助放疗是中枢神经细胞瘤的一种有效治疗策略。     

Central neurocytoma: its differentiation from intraventricular oligodendroglioma

Two patients with intraventricular tumours are presented. Both had similar features on light microscopic examination. On the basis of the specific immunohistochemical staining patterns and the ultrastructural findings, one was diagnosed as a central neurocytoma while the other was diagnosed as an intraventricular oligodendroglioma. The possibility of central neurocytoma should be considered in all young patients including children presenting with an intraventricular lesion. Definitive diagnosis requires electron microscopic and immunohistochemical studies.     

中枢神经细胞瘤的诊断和显微手术治疗

目的探讨中枢神经细胞瘤（CNC）诊断及治疗经验。方法回顾性分析16例CNC的诊断及显微手术治疗情况。采取纵裂-胼胝体-脑室入路5例,经皮质造瘘侧脑室入路9例,经枕下正中小脑蚓部入路1例,直接开颅切除1例。术后3例行放射治疗。结果术前误诊率62．5％。病理分级：WHOⅡ级7例,Ⅱ-Ⅲ级3例,Ⅲ级1例,未定级5例。病变全切除10例,次全切除4例,部分切除2例。除1例失访和1例复发外,其他病例恢复良好。结论CNC多数位于脑室系统,在影像学上有其特点。选择适当的手术入路行显微手术治疗预后良好。     

中枢神经细胞瘤的影像学分析与鉴别诊断

目的探讨中枢神经细胞瘤（central neurocytoma,CNC）的影像学特征,提高术前诊断准确率。方法回顾性分析21例经手术病理证实的中枢神经细胞瘤的CT及MRI表现,分析中枢神细胞瘤的影像特点。结果肿瘤多位于侧脑室前中部室间孔区,常跨透明隔生长,CT平扫多呈等密度及较高密度,常散在钙化灶,MRI表现为T1WI上呈不均匀等信号或稍低信号,T2WI上呈不均匀稍高信号,病灶边缘可见多发小囊状影及病灶和侧脑室边缘相连的丝网状影,病灶内较常见血管流空信号,增强后病灶不均匀明显强化。结论中枢神经细胞瘤影像学表现具有一定特异性,其特征性有助于提高术前诊断正确率。