颅内神经元及神经元与神经胶质混合性肿瘤的MRI诊断(附8例分析)

目的 探讨颅内神经元及神经元与神经胶质混合性肿瘤的MRI表现及诊断价值。方法 8例病人均经手术病理证实为神经元及神经元与神经胶质混合性肿瘤，回顾分析其MRI资料。结果 神经节细胞瘤MRI的T1WI上为低信号，T2WI上为高信号，增强扫描无强化，无占位效应；神经节细胞胶质瘤MRI特征性表现为边界清楚的囊性病变伴有壁内结节，T1W1上为低信号，T2W1上为高信号，注射Gd-DTPA后，囊壁及结节增强；胚胎发育不良神经上皮肿瘤表现轻度占位效应，无瘤周水肿，病灶位于皮层，可有皮层下白质受累，边界清楚，肿瘤呈分叶状或脑回状外观，T1WI上为低信号，T2WI上为高信号，增强扫描少数病例表现轻度增强。结论 神经元及神经元与神经胶质混合性肿瘤是中枢神经系统一种少见的良性肿瘤，癫痫发作为常见症状，MRI检查对确定诊断有重要价值，但须综合考虑临床资料，方能减少误诊率。

Intracerebral Neuronal and Mixed Neuronal-Glial Tumors:MRI Evaluation (Analysis of 8 Cases)

Objective To study the MRI findings and diagnostic value of intracerebral neuronal and mixed neuronal-glial tumors.Methods We retrospectively analyzed MRI findings of 8 patients with surgically and pathologically confirmed neuronal and mixed neuronal-glial tumors.Rusults Appearances of gangliocytoma (GC) on MRI were hypointense on T1WI, hyperintense on T2WI, and had no enhancement on gadolinium-enhanced T1WI. GC had no mass effect. In gangliogliomas (GG), a well-defined cystic mass with solid mural nodule was typically seen on MRI, hypointense on T1WI, hyperintense on T2WI. On post-gadolinium scan, nodule and cystic wall were enhanced. Dysembryoplastic neuroepithelial tumors (DNT) were intracortical tumors with/without subcortical area invasion, and had less mass effect and no peritumoral edema. DNT had a well-demarcated, multilobulated or gyriform appearance. DNT was hypointense on T1WI and hyperintense on T2WI, and a contrast enhancement of the lesion was observed on post-gadolinium scan in few cases.Conclusion Intracerebral neuronal and mixed neuronal-glial tumors are rare benign neoplasms of CNS,The most common initial symptom was seizures. MRI is a valuable method to establish the diagonsis, misdiagnosis can be decreased when combined with clinical history.