侧脑室肿瘤的MRI诊断及鉴别诊断

目的:分析侧脑室肿瘤的MRI影像特点，提高侧脑室肿瘤诊断的准确性。方法:回顾性分析28 例经手术病理证实的侧脑室占位性病变的MRI影像学表现。 结果:大多数侧脑室肿瘤具有年龄和性别特征。如脑膜瘤好发于30~50岁，女性多见；中枢神经细胞瘤发病年龄在20~40岁；转移瘤均大于40岁。不同的侧脑室肿瘤，其好发部位不同。室间孔区好发中枢神经细胞瘤，侧脑室体部好发星形细胞瘤，脑膜瘤和转移瘤好发于侧脑室三角区。不同侧脑室肿瘤的MRI表现有所不同，部分具有特征性表现。脑膜瘤增强后呈明显均匀强化。星形细胞瘤，邻近脑组织受侵伴水肿，增强扫描可见不均匀强化。中枢神经细胞瘤，围绕透明隔生长，周围可见多发囊变，增强可见不均匀强化。少突胶质细胞瘤内可见多发钙化灶。转移瘤，增强扫描大多数可见环形强化。室管膜瘤，增强扫描明显强化，容易侵犯邻近脑实质。结论:MRI影像学表现结合肿瘤的部位、发病年龄、强化程度和磁共振波谱(MRS)表现等可以提高侧脑室肿瘤的术前诊断准确率。

MRI diagnosis and differential diagnosis of lateral ventricular tumor

Objective:To analyze MRI manifestation of lateral ventricular tumors and improve diagnostic accuracy of tumors in the lateral ventricular.Methods:Analysising MRI findings of 28 cases of lateral ventricle lesions con-firmed by surgery and pathology.Results:Most of the lateral ventricle tumors had features of specific age and gender. All meningiomas occured 30 ~50 years old in women,and the central neurocytoma occurred 20 ~40 years old.The metastatic tumors occurred above 40 years old.Part of the tumors had specific location.Astrocytoma frequently occured in lateral ventricular body while central neurocytoma frequently occured in foramen of Monro.Meningiomas and meta-static tumors frequently occured in ventricular trigonum.MRI manifestation of different lateral ventricle tumors was dif-ferent,part of the tumors had specific appearances.Meningioma was obvious homogeneous contrast.Astrocytoma ten-ded to heterogeneous enhancement.Central neurocytoma's growth was closely related to the septum pellucidum,multi-ple cystic around the tumor edge.There were multiple calcifications within the oligodendrocytes.Metastasis tumor showed ring enhancement after contrast administration.Ependymomas were obvious enhancement and tended to invade brain parenchyma easily.Conclusion:MRI imaging combined with tumor location,the age of the patient,the degree of lateral ventricle tumors contrast and magnetic resonance spectroscopy can improve the preoperative diagnostic accuracy.