颅内海绵状血管瘤的CT和MRI诊断

目的 探讨CT和MRI对颅内海绵状血管瘤的表现和诊断价值。资料与方法 经手术病理证实的颅内海绵状血管瘤22例，其中脑内型海绵状血管瘤21例，脑外型海绵状血管瘤1例。10例行CT检查，16例行MRI检查，13例行MRA检查。结果 脑内型海绵状血管瘤可位于脑内任何部位，单发病灶多见，周围无或轻度水肿，无明显占位效应。CT平扫为稍高密度影，钙化占72．7％，增强扫描大都无强化；MR T1WI表现为桑葚状混杂高信号．周围有云絮状低信号环，增强后病灶大都无强化；MRA检查未见异常血管。脑外型病灶位于中颅窝、鞍旁，MRI呈类似哑铃形较均匀的稍长T1、长T2信号，增强扫描见明显均匀强化．MRA检查未见异常血管。结论 脑内型海绵状血管瘤的MRI表现较有特异性，结合CT和MRA可明确诊断；脑外型者易误诊，对CT和MRI表现类似的中颅窝脑膜瘤，应考虑到本病的可能。

CT and MRI Diagnosis of Intracranial Cavernous Hemangioma

Objective To investigate the value of CT and MRI in the diagnosis of intracranial cavernous hemangioma.Materials and Methods 22 cases of intracranial cavernous hemangioma confirmed with pathology were analyzed. 21 cases were intraaxial lesions, 1 case were dural cavernous hemangiomas in middle fossa. 10 cases were underwent with CT scan, 16 cases with MRI examination,13 cases with MRA examination.Results The lesion of intracerebral cavernous hemangioma could be located in every region of the brain, which single lesion was more often and most lesions had no or slightly edema without space-occupying effect. Slight hyperdensity mass were appeared in plain CT scan, and calcification were seen in 72.7% of the mass,the most of them were shown without enhancement. The characteristic MRI features were multiberry-like inhomogenous intensity with flocculent hypointensity ring. No enhencement could be seen. There were normal appearance in MRA. Extraaxial cavernous hemangioma were located in the middle fossa and parasellar, which had dumb-bell shape, and homogenous slight hypointensity on T 1WI and hyperintensity on T 2WI images with markedly enhancement.Conclusion The MRI findings of intracerebral cavernous hemangioma are specific, combined with CT and MRA could make a correct diagnosis. Misdiagnosis of dural cavernous hemangiomas is often to be done,so we should take the possible diagnosis of dural cavernous hemangiomas into account when the CT and MR image features of tumors are similar to meningioma which located in the middle fossa.