颅内血管母细胞瘤的MRI表现及病理分析

目的探讨颅内血管母细胞瘤的MRI表现及其病理基础。方法回顾性分析26例颅内血管母细胞瘤的MRI和病理资料,分析其影像学特点。结果单发病灶22例,多发病灶4例,共31个病灶,均位于后颅窝内,其中右侧小脑半球14个,左侧小脑半球9个,4脑室下方小脑下蚓部2个,延髓4个,4脑室2个。19个病灶呈囊结节型、1个病灶呈囊肿型、11个病灶呈实质型或偏实质型。病灶囊性区呈长T1长T2信号,实性区T1WI多呈稍长T1稍长T2信号,其中12个病灶内见稍短T1信号,增强示实性区明显强化,囊性区无强化,3个囊结节型病灶囊壁轻度强化。DWI实性区呈低信号。MRS示胆碱峰明显升高,肌酸及N-乙酰天门冬氨酸峰明显减低或接近消失,可见高尖的脂质及乳酸峰。结论颅内血管母细胞瘤常规MRI及功能成像表现均有一定特征性,MRI对其定位、定性均有较大的临床诊断价值。

MRI features and pathological analysis of intracalvarium hemangioblastomas

Objective To discuss MRI and pathological features of intracranial hemangioblastoma. Methods MRI data of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively. Results There were 22 cases with single lesion and multiple lesions in 4 cases. And a total of 31 lesions located in the posterior cranial fossa, including 14 lesions in right cerebellar hemispheres, 9 lesions in left cerebellar hemispheres, 2 lesions in cerebellar inferior vermis, 4 lesions in medulla oblongata, and 2 lesions in fourth ventricle. Ninteen lesions showed cystic nodular type, 1 lesion was cystic type, 11 lesions showed parenchymal type or partial parenchyma type. Cystic lesions showed long T1 and long T2 signal, T1WI of solid area showed slightly long T1 and slightly long T2 signal, of which 12 lesions were slightly shorter T1 signal. Solid areas significantly enhanced, cystic area had no enhancement, but cystic wall of 3 cystic nodular lesions were slightly enhanced. DWI of solid areas showed low signal. MRS showed the peak of Cho obviously increased, and the peaks of Cr and NAA obviously decreased or nearly disappeared, and the high peak of lipids and lactate were observed. Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics. MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.