幕上脑实质内室管膜瘤MR诊断价值

目的分析幕上脑实质内室管膜瘤MR特征,旨在提高术前诊断正确率。方法回顾性分析7例幕上脑实质内室管膜瘤影像特征,所有病例均经手术病理证实。7例均行MR常规序列平扫及增强扫描。主要观察肿瘤的部位、形态、信号、强化特点及瘤周水肿程度。结果左额叶3例,左颞顶叶2例,右颞叶2例。5例表现为囊实性肿块,2例为实性肿块。肿瘤实性部分T1WI表现为不均匀低信号、T2WI及FLAIR表现为高信号,DWI表现为高信号,增强扫描肿瘤实性部分不均匀明显强化6例,轻度强化1例。肿瘤囊性部分表现为长T1、长T2信号,FLAIR表现为高信号,DWI表现为低信号。7例肿瘤边缘均可见分叶,边界均清楚,瘤周围水肿6例为轻度,1例为中度。结论幕上脑实质内室管膜瘤有一定的特点:好发于脑室旁脑实质,边缘呈分叶状,边界清楚,实性部分明显强化,DWI上为高信号,中老年人好发。当临床遇到有类似MR表现的脑实质肿瘤时,术前鉴别诊断应考虑到本病。

The Value of MR Diagnosis on Intraparenchymal Ependymoma

Objective To improve the diagnostic accuracy by investigating the imaging characters of the intraparenchymal ependymoma. Methods The imaging characters of 7 cases intraparenchymal ependymoma confirmed by surgery and pathology were retrospectively analyzed. Routine MR and contrast-enhanced were performed in all patients. The tumour characters including locations, form, signal,enhancment and edema were observed. Results 3 cases located at Left frontal lobe, 2 cases at left temporalis, 2 cases at right temporalis.5 cases were partial cystic type and 2 cases were solid. The solid part of the tumors demonstrate uneven hypo-intense signals on T1WI, slight hyper-intense signals on T2WI and Flair, hyper-intense signals on DWI and 6 cases were remarkably uneven enhanced after adminstrating constrast medium, 1 case was slightly enhanced. The cystic part of tumors demonstrate long TI and long T2 signal, hypo-intense signals on Flair and DWI. The margins of tumor were clear and sublobes can be observed in 7 cases. The cerebral edema around focus was light in 6 cases and medium in 1 case. Conclusion Some characters of the intraparenchymal ependymoma tumours can been observed, such as the predilection site nearing the lateral ventricle, edge divided, the clear margin, the remarkably enhanced solid part, hyperintensity on DWI and ofen occurred in aged people. If facing to cerebal tumours with these characters in clinical, intraparenchymal ependymoma should be considered.