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。

Intracranial neuronal and mixed neuronal-glial tumors:MRI diagnosis

Objective:To analyze MRI features of intracranial neuronal and mixed neuronal-glial tumors so as to improve the diagnostic accuracy.Methods:MRI findings as well as clinical data of 22 patients with surgically and pathologically confirmed neuronal and mixed neuronal-glial tumors were retrospectively analyzed.Results:All five central neurocytomas were located in the lateral ventricles,which showed heterogeneous hypointensity on T1WI and hyperintensity on T2WI,and demonstrated heterogeneous enhancement.One gangliocytoma in the temporal lobe appeared hypointensity on T1WI and hyperintensity on T2WI,and had no enhancement and mass effect.Among twelve cases of gangliogliomas,six cases were in the temporal lobe,cystic appearance and an enhanced mural nodule were demonstrated in five of them.Two cases of dysembryoplastic neuroepithelial tumors showed heterogeneous hypointensity on T1WI and hyperintensity on T2WI,and had no enhancement and mass effect.Desmoplastic cerebral ganglioglioma of infancy in one case was intracortica1 tumor,which showed heterogeneous hypointensity on T1WI,hyperintensity on T2WI and ring-like enhancement without edema.One case of papillary glioneuronal tumor was in the temporal lobe and showed circumscribed cyst with irregular mural nodule,cystic wall and mural nodule were enhanced.Conclusion:Intracranial neuronal and mixed neuronal-glial tumors has some characteristic imaging features and location predilection.It is possible to make a preoperative suggestive diagnosis by MR imaging combined with patient's age and clinical history.