不典型髓母细胞瘤的MRI诊断

目的 探讨不典型髓母细胞瘤的MRI表现，提高对髓母细胞瘤的认识。资料与方法 搜集经MRI诊断、临床及病理证实的12例髓母细胞瘤，其中8例为原发性髓母细胞瘤，4例为髓母细胞瘤转移；8例有增强MRI扫描资料，1例作颈胸椎MR扫描，分析其MRI表现。结果 8例原发性髓母细胞瘤中，1例表现为两侧小脑半球多发结节状病灶，所有病灶均明显强化；4例病变居于第四脑室内；2例病变侵犯桥臂；1例表现为完全囊性病变。4例髓母细胞瘤转移中，1例为上颈髓内转移；1例为颈、胸椎多发椎体转移；2例为两侧大脑半球内多发转移。结论 髓母细胞瘤的不典型表现可为两侧小脑半球多发病变，居于第四脑室内或侵犯桥臂、完全囊变等，其不典型转移方式可为骨转移、脑内或脊髓内转移等。

MRI Diagnosis of Atypical Myeloblastoma

Objective To discuss MRI features of atypical myeloblastoma, to make a further understanding of the disease.Materials and Methods MRI findings in 12 cases with pathologically-proved myeloblastoma were retrospectively analyzed. Of the total 12 cases, primary myeloblastoma was seen in 8 and metastatic myeloblastoma in 4. Enhanced MRI scanning was carried out in 8 cases, while cervical-thoracic MRI scanning in one.Results Of 8 cases with primary myeloblastoma, the lesion was presented as multiple nodules at bilateral cerebellum with marked enhancement in one, located in the fourth ventricle in 4, and pedunculus cerebellaris medius was affected in 2. In the 4 cases with metastases, the lesions were found in upper cervical spinal cord (n=1), in both cervical and thoracic vertebrae (n=1) or in bilateral cerebral hemisphere (n=2). Conclusion On MRI, the atypical myeloblastoma can be manifested as multiple lesions in bilateral cerebellum and in the fourth ventricle, and as the involvement of pedunculus cerebellaris medius. The lesions can totally cystic degeneration. The bone, brain and spinal cord can be metastasized.