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胚胎发育不良性神经上皮瘤的MRI表现

作者:李 鹤 宋继安 薛 鹏 陈 勇 周 杰

所属单位:南方医科大学附属医院(郑州市人民医院)放射科(河南 郑州 450003)

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摘要

目的探讨胚胎发育不良性神经 上皮肿瘤(DNT)的MRI表现。方法 回顾 性分析经术后病理证实的19例DNET患者 的MRI资料。结果 19例中,13例幕上,6 例幕下,均单发,边界清楚;MRI表现多 样,形态多呈类圆形或不规则斑片状,6 例呈囊实性病变,囊性部分呈长T1、T2 信号,实性部分呈等或稍长T1、T2信号 结节或分隔影,增强后实性部分明显强 化伴4例囊壁强化;3例囊性病变,呈长 T1、T2信号,增强后1例见内轻度分隔样 强化;另10例均呈稍长T1、T2信号,内可 见更长T1、T2信号,部分内见等信号分 隔样结构,增强后7例轻度环状、条片状 不均匀强化;19例FLAIR均呈欠均匀高信 号;13例(13/19)无水肿及占位效应,6 例(6/19)具有轻微水肿,与病变大小不 成比,且占位效应相对较轻。结论 DNET MRI表现有一定的特征性,结合年龄及部位 特点,应考虑本病的可能性。

Objective To study the MRI features of intracranial dysembryoplastic neuroepithelial tumor(DNT). Methods 19 cases proved by pathology were retrospectively analyzed with MRI data. Results 18 lesions were single and well-demarca-ted, located mainly in the cortical to subcortical area,1 lesion located mainly in the fourth ventricle. Imaging appearances seemed to be diverse on MRI.shape more showed round or patching,All lesions mainly appeared hypo-intense or slightly hypo-intense on T1WI and hyper-intense or slightly hyper-intense on T2WI except for mixed signal intensity of hemorrhage or calcification.It was obvious that 6 lesions experienced cystic change and 5 of which had nodus in capsule wall,which appeared isointense onT1WI and isointense or slightly hyperintense on T2WI.all lesions appeared hyper-intense or slightly hyper-intense with on FLAIR (fluid attenuated inversion recovery). After injecting gadolinium,the lesions appeared to have no change (n=4),mild enhancement (n=8),obvious enhancement(n=7), nodular enhancement (n=6),intratumoral circular enhancement (n=5) 13 lesions showed no mass effect and edema,6 lesions showed slight mass effect and edema. Conclusion MRI of DNET have some characteristic imaging features,which may be posible for the diagnosis in combination with age and tumor locations .

【关键词】肿瘤;神经上皮;磁共振成像

【中图分类号】R73

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.03.02

前言

胚胎发育不良性神经上皮瘤(dysembryoplastic neuroepithelial tumor, DNT)是一种中枢神经系统罕见的神经元及混合神经元-胶质肿 瘤。临床及影像学对其认识仍不足,本研究现回顾性分析经病理证实 的19例DNT患者MRI资料,结合文献复习,探讨其MRI表现,以提高对它 的认识。