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小脑血管母细胞瘤的MRI表现分析

作者:陈驰华 严小兰 廖凯兵

所属单位:湖北省中西医结合医院放射科(湖北 武汉 430015)

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摘要

目的 探讨小脑血管母细胞瘤的 MRI表现。方法 对经手术病理证实为小脑 血管母细胞瘤31例患者临床资料进行回顾 性分析,均行MRI平扫和增强扫描,分析 影像学表现。结果 23例大囊小结节型为 类圆形囊性包块,正常脑实质有清晰分 界;囊液TI低信号,T2高信号;囊壁TI等 信号,T2高信号;14例肿周存在高信号水 肿;FLAIR上稍高信号。增强扫描显示, 瘤内结节均明显强化,囊液无强化。6例 实质型8个肿块,呈规则团状分布,与正 常脑实质无清晰分界,瘤周存在水肿;TI 低信号,T2高信号,FLAIR上为高信号, 增强扫描显示,肿瘤明显强化,病灶中囊 性坏死区域未见强化。2例单纯囊型,TI 等信号,T2低信号,FLAIR等信号,增强 扫描未见明显强化。结论 MRI是临床诊断 小脑血管母细胞瘤重要影像学方式,在疾 病定性诊断中具有较高的应用价值。

Objective To investigate the MRI findings of cerebellar hemangioblastomas. Methods The clinical data of 31 patients with cerebellar hemangioblastomas confirmed by surgery and pathology were retrospectively analyzed. All patients underwent MRI plain scan and enhanced scan. The imaging findings were analyzed. Results 23 cases of big cyst and small nodule type were quasi-circular cystic masses and the normal brain parenchyma had clear boundaries; The cyst fluid TI showed low signals while T2 showed high signals; Cyst wall TI showed equal signals while T2 high signals; There were high signal edemas around the masses in 14 cases; There were slightly higher signals on FLAIR. Enhanced scan showed that the intratumoral nodules were significantly enhanced and the cystic fluid was not enhanced. In 6 cases of solid type, 8 masses distributed in regular clumped shape and had no clear boundaries with normal brain parenchyma. There were edemas around the tumors; TI showed low signals while T2 showed high signals. There were high signals on FLAIR. Enhanced scan showed that the tumors were significantly enhanced and the cystic necrosis regions in the lesions were not enhanced. 2 cases were simple cystic type. TI showed equal signals while T2 showed low signals. There were equal signals on FLAIR. Enhanced scan showed no significant enhancement. Conclusion MRI is an important imaging method of clinical diagnosis of cerebellar hemangioblastomas and it has higher application value in qualitative diagnosis of disease.

【关键词】血管母细胞瘤;小脑;磁共振成像;表现

【中图分类号】R445.3;R739.4

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.03.008

前言

小脑血管母细胞瘤发病率较低,占颅内肿瘤的1%~2%,幕下小脑 半球属于小脑血管母细胞瘤的高发部位,其次为脊髓瘤[1]。有学者指 出,MRI诊断颅内血管母细胞瘤具有特征性,在疾病诊治、评估预后中 具有重要作用[2]。本文回顾性分析了经手术病理证实为小脑血管母细 胞瘤31例的临床资料及MRI影像学资料,现报道如下。