摘要
目的 探讨幕上及椎管内原始神经外胚层肿瘤的MRI特点 ,以提高正确诊断率。方法分析经手术病理证实的 9例原始神经外胚层肿瘤的MRI表现 ,其中男 6例 ,女 3例 ,平均年龄 32 6岁。术前 9例均行MR常规平扫检查 ,分别采用SE、快速自旋回波 (FSE)、液体衰减翻转恢复 (fluidattenuatedinversionrecovery ,FLAIR)序列 ;其中 2例行扩散加权成像 (diffusionweightedimaging ,DWI) ,4例行增强检查。结果 幕上大脑半球 8例 ,包括额颞区与枕叶各 2例 ,额顶、顶、额各 1例 ,第3脑室后部 1例。胸段椎管内 1例。病灶普遍较大 ,最大为 6 0cm× 6 9cm× 4 9cm。除第 3脑室后部 1例病变呈类圆形外 ,其余 7例形态极不规则 ,且水肿相对较轻 ,边界清楚 ,偏实性多见。其中发生小的囊变者 2例、合并出血 4例 ,3例病灶内可见血管流空影。呈稍长T1WI信号、长或稍长T2 WI信号 4例 ;混杂T1WI、T2 WI、FLAIR信号 4例 ;DWI 2例显示为明显高信号。其中增强 3例呈极不均一不规则“印戒”样强化 ,并显示室管膜扩散。椎管内 1例呈不规则形软组织肿块影 ,伴相邻骨质破坏肌群受累 ,显示轻度增强。结论 原始神经外胚层肿瘤的MR表现较具特征性 ,但其确诊仍依赖病理学诊断。
Objective To analyze the MRI features of supratentorial and intraspinal primitive neuroectodermal tumors (PNET) and improve the diagnostic accuracy. Methods MRI manifestations of 9 PNET diagnosed via operation and pathological examination were analyzed.There were 6 men and 3 women, and the mean age was 32.6 years.In all 9 cases, conventional plain MR scans were performed, including spin echo (SE), fast spin echo (FSE), and fluid attenuated inversion recovery (FLAIR) sequences.Diffusion weighted images (DWIs) and postcontrast MR images were obtained in 2 and 4 cases, respectively. Results The 8 cases with supratentorial lesions included fronto-temporal lesion in 2 cases, occipital lesion in 2 cases, fronto-parietal lobe, parietal lobe, frontal lobe lesion in each 1 case, and posterior part of third ventricle in 1 case, and the lesion located in the thoracic spinal canal in 1 case.All the lesions were quite large in volume, and the largest one was 6.0 cm×6.9 cm×4.9 cm.Except for the round-like lesion in the posterior part of third ventricle, the other 7 supratentorial lesions were irregular in shape, well demarked, and often with solid consistency and slight peritumoral edema.The lesions demonstrated long T_1 and long or slightly long T_2 signal intensity in 4 cases, mixed signal intensity on T_1WI, T_2WI, and FLAIR images in 4 cases.Small cystic degeneration could be seen in 2 cases, hemorrhage in 4 cases, and flow void vessels in 3 cases.3 cases demonstrated irregular ring-like enhancement and ependymal dissemination.The lesion in the thoracic canal demonstrated as a slightly enhanced soft tissue mass with adjacent bony destruction and muscle infiltration.Conclusion MR findings of PNET are rather characteristic, but the final diagnosis relies on pathology.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第2期149-152,共4页
Chinese Journal of Radiology
关键词
诊断
幕上肿瘤
椎管
原始神经外胚层肿瘤
磁共振成像
Supratentorial neoplasms
Spinal canal
Neuroectodermal tumors, primitive
Magnetic resonance imaging
