听神经瘤临床行为与其磁共振信号和病理特征之间的相关性研究

目的　分析听神经瘤的大小、生长速率及增殖与其磁共振信号、组织学特征之间的相互关系。方法　回顾分析听神经瘤 4 3例 ,依MR信号分为均匀、不均匀及囊性变 ,组织学包括AntoniA、AntoniB以及纤维化、含铁血黄素沉淀、黄色瘤样细胞。结果　信号均匀的听神经瘤肿瘤较小、生长较慢、增殖指数较低 ,组织学以AntoniA结构占优 ;不均匀和囊性听神经瘤肿瘤较大、生长较快、增殖指数较高 ,以混合型结构占优 ;不均匀和囊性听神经瘤中含铁血黄素沉淀、黄色瘤样细胞以及不均匀听神经瘤的纤维化明显增多 ,它们均有统计学意义。结论　较大的听神经瘤不仅MR表现为不均匀信号 ,而且组织学主要表现混合型结构 ,也可能有其他变化 ,主要是含铁血黄素沉淀和囊性变。

The relationship between MR findings, histopathologic appearance and tumor's behaviour.

Objective To analyze the relationship between MR findings, its histopathologic features and the size, growth rate, prolifrative index of acoustic neuromas. Methods 43 acoustic neuromas were retrospectively analyzed. The acoustic neuroma were measured and classified as homogeneous, heterogeneous and cystic. Pathologic studies evaluated the prevalence of Antoni A, and Antoni B, the amont of fibrosis, and the presence of siderin loaded macrophages, xanthomatous cells and cysts. Results The homogeneous acoustic neuroma, which were predominantly made of Antoni A, were significantly smaller, lower of growth rate and proliferation index than the heterogeneous and cystic acoustic neuroma. Heterogeneous and cystic acoustic neuroma, which were predominantly made of mixed type, showed significantly higher percentage of hemosiderin deposits, xanthomatous cells and fibrosis than homogeneous acoustic neuromas. Conclusions A larger acoustic neuroma is not only heterogeneous MR aspects, but also mixed pathological appearance. Furthermore, it is has other pathologic changes, mainly hemosiderin deposits and cystic formation.