颅骨海绵状血管瘤的CT和MRI诊断(附11例报告)

目的:分析颅骨海绵状血管瘤的CT和MRI特点。方法:回顾性分析11例(男3例,女8例,年龄12~65岁,平均44岁)经病理证实的颅骨海绵状血管瘤的临床表现、术前CT平扫和MRI平扫和增强扫描资料,观察肿瘤的形状、密度、边界、MRI信号变化、增强表现及周围软组织情况,根据颅骨外板是否破坏,将肿瘤分两组,比较肿瘤最大径的组间差异。结果:所有病例术前均表现为无痛性皮下肿物。7例(64%)位于额骨,顶骨和枕骨各2例。病变均表现为椭圆形,边界清晰,边缘无硬化。CT值自117~1048HU不等。7例(64%)外板破坏的肿瘤最大横径为(2.7±0.80)cm,与4例(37%)外板无破坏的肿瘤大小(2.33±0.88)cm差别无统计学意义(P=0.488)。MRI平扫均表现为高低信号混杂影,增强后强化不均匀,强化幅度不一。周围软组织和脑实质信号正常。结论:颅骨海绵状血管瘤表现出一定的破坏颅骨外板向颅外生长倾向,综合CT和MRI检查有助于更好地显示该病的影像学特点。

CT and MRI diagnosis of calvarial cavernous hemangioma(report of 11 cases)

Objective：To investigate the CT and MRI features of calvarial cavernous hemangioma.Methods：To retrospectively analyze the clinical data,pre-operative CT and MRI findings of 11 patients（3 males,8 females,age range,12～65 years old,mean age,44 years old） with calvarial cavernous hemangioms which were pathologically diagnosed.The radiological analysis was focused on tumor shape,density,margin,the signal change,enhancement degree and surrounding structures on MRI.The maximal diameter was calculated and compared between the tumors with destruction of external lamina and those without.Results：Clinically,11 cases were demonstrated as indolent subcutaneous mass.Seven cases located in frontal bone（64%）,2 in parietal bone and 2 in occipital bone.They were ellipse in shape with clear margin.The CT attenuation ranged from 117 HU to 1048 HU.Seven cases showed destruction of outer plate with maximal diameter of（2.7±0.80） cm and 4 cases without destruction were（2.33±0.88） cm in diameter.The difference was not significant（P=0.488）.On MRI,the tumors were heterogeneous in signal and enhanced variably.The signals of the surrounding structures were normal.Conclusion：Calvarial cavernous hemangioma shows a growth tendency out of cranium by invasion of outer plate.Combination of CT and MRI findings are helpful for the diagnosis.