中分化松果体实质瘤影像学表现(附31例报告)

目的 观察中分化松果体实质瘤的CT、MRI表现。方法 回顾性分析31例经手术和病理证实的中分化松果体实质瘤患者,观察CT、MRI图像上病灶的形态、边界、大小、信号(密度)、强化方式及幕上脑积水情况等。结果 31例中分化松果体实质瘤肿瘤形态多为不规则分叶状(23/31,74.19%),部分边界不清(18/31,58.06%),直径以20~50 mm居多(27/31,87.10%)。CT均为等密度或稍高密度,部分可见囊变区(23/31,74.19%)及钙化灶(5/20,25.00%),少数可有出血(4/31,12.90%)。MRI上T1WI以等稍低信号为主(20/29,68.97%),T2WI上以等稍高信号为主(20/29,68.97%),部分信号混杂(9/29,31.03%)。病灶多呈不均匀明显强化(20/29,68.97%),部分可见邻近脑膜强化(17/29,58.62%)。31例患者均有不同程度的幕上脑积水及第3脑室前下疝。结论 中分化松果体实质瘤具有一些典型的影像学征象,提高影像学认识有助于术前诊断。

Imaging features of pineal parenchymal tumor of intermediate differentiation: A report of 31 cases

Objective To observe the imaging features of pineal parenchymal tumor of intermediate differentiation (PPTID). Methods Totally 31 patients with PPTID confirmed by surgery and pathology were analyzed retrospectively. The features on CT/MRI images were observed and analyzed, including the shape, margin, size, signal, dense, enhancing patterns supratentorial hydrocephalus and so on. Results In 31 cases, the shape of most tumors was irregularly lobulated (23/31, 74.19%), the tumor margin was ill defined (18/31, 58.06%) and the size was 20 to 50 mm mostly (27/31, 87.10%). On CT images, the tumors were isodense or slightly hyperdense, and cystic formation (23/31, 74.19%) and calcification (5/20, 25.00%) can be observed in some cases. On MRI images, the lesions show isointense or slightly hypointense on T1WI (20/29, 68.97%), and isointense or slightly hyperintense on T2WI (20/29, 68.97%), homogeneous or heterogeneous. Hemorrhage is rare (4/31, 12.90%). On enhanced TIWI images, the tumor was heterogeneously and apparently enhanced (20/29, 68.97%), and the meninges near the lesion also enhanced in some cases (17/29, 58.62%). Supratentorial hydrocephalus and the third ventricle herniation were found in all cases. Conclusion PPTID shows some characteristic features on CT/MRI imags, which might be helpful for preoperative diagnosis.