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·头颈疾病·

小脑实性血管母细胞瘤的CT与MRI诊断

作者:陈 峥1 关惠英1 黄晓健1 吴永峻2

所属单位:1.广东省江门市开平市中心医院放射科 (广东 江门 529300)2.广东医科大学附属医院 (广东 湛江 524001)

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摘要

目的 探讨小脑实性血管母细胞瘤的影像表现特点。方法 搜集 7例经病理证实的小脑实性血管母细胞瘤的MRI资 料,详细分析其MRI表现。结果 5例肿瘤位于小脑半球,2例位于小脑蚓部。5例CT检查,4例平扫肿块表现为混杂 等、低密度,1例呈均匀稍高密度。3例边界不清,周围可见水肿区;2例边界较清,周围可见少许水肿或不明显水 肿;增强扫描均表现为显著强化。7例 MRI检查,表现为T1WI呈等、稍低信号或混杂信号,T2WI及FLAIR上呈高信 号,5例肿块内部或周围可见血管流空影,增强后肿瘤呈显著强化;DWI上均呈低信号;2例 MRS可见低Cho和NAA 峰,明显增高的Lip峰。结论 CT与MRI对小脑实性血管母细胞瘤的诊断具有重要价值。

Objective To probe into imaging performance characteristics of the cerebellum solid hemangioblastoma. Methods MRI manifestations of the seven cases cerebellum solid hemangioblastoma proved by pathology were analysed in detailed. Results 5 cases located in cerebellar hemisphere, 2 cases located in the cerebellar vermis. 5 cases CT scan, of 4 cases plain scan mass were mixed and/or low density, 1 case was slightly high density homogeneously. 3 cases were obscure boundary and edema around area. 2 case were boundary clearly and around a few edema or not obvious edema. Enhanced scan all performance was significantly improved. 7 cases MR scan, slightly low signal or mixed signals on T1WI, high signal on T2WI and FLAIR, vascular flow empty mass inside or around visible in 5 cases, all the tumor was significantly enhancement and low signal on DWI. 2 cases were low Cho and NAA peak as well significantly higher Lip peak. Conclusion CT and MRI have an important value in diagnosis of the cerebellum solid hemangioblastoma.

【关键词】小脑;血管母细胞瘤,实性;磁共振成像

【中图分类号】R742.8+2

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2017.02.005

前言

血管母细胞瘤(hemangioblastoma,HB)又称血管 网状细胞瘤、血管网织细胞瘤,来源于血管内皮细 胞,是中枢神经系统一种高度血管分化的良性肿瘤, 是颅内少见肿瘤,好发于小脑,约占颅内肿瘤的1.1% ~2.4%,占后颅窝肿瘤的7%[1],血管母细胞瘤分为囊 性和实质性,以囊性为多见,其表现具有特征性、诊 断较易,而实性约占30%[2],肿瘤血管丰富,诊断较 为困难,容易造成误诊。笔者对2011年12月至2016 年11月收集7例经病理证实的实性血管母细胞瘤的CT 与MRI资料,总结其影像表现特点,旨在提高对本病 的认识水平。