摘要
目的探讨发生在鞍上和半球的脑室外神经细胞瘤(EVN)的CT和MRI影像学特点,提高影像学鉴别诊断能力。方法回顾性分析14例经手术病理证实的EVN患者的影像学资料,患者行CT和MRI扫描。结果 14例EVN患者中,男5例,女9例。5例病灶位于鞍上,年龄4~63岁,中位年龄48岁;9例病灶位于大脑/小脑半球,年龄2~49岁,中位年龄19岁,所有患者术前均被诊断为其他肿瘤。鞍区EVN表现为较均匀的实性肿块,在CT上呈等密度,MR呈等/稍低T1信号、等/稍高T2信号;病灶内钙化(40%)、囊变坏死出血少见、显著强化为其影像学特征。本组发生在大/小脑半球的EVN均为囊实混杂型,额叶受累约占55.6%;影像学特征包括实性结节囊变坏死(66.7%)和钙化(22.2%)、囊腔内纤维分隔、边界清楚、灶周无或轻度水肿,实性结节、囊壁和纤维间隔均可强化。结论 EVN是一类罕见的肿瘤,但是在CT和MRI上具有一定的影像学特征。对于中老年鞍区实性占位(尤其是内分泌检查正常的患者)和中青年半球囊实混杂型占位(尤其是累及额叶的病变),应该把EVN列为鉴别诊断。
Objective To study the CT and MRI features of extraventricular neurocytoma（ EVN） of the sellar region and hemisphere,thus to improve the ability of differential diagnosis. Methods Imaging data of 14 patients with pathologically proved EVN were analyzed retrospectively. The patients underwent plain CT,non-enhanced and enhanced MRI. Results Among the 14 cases,there were 5 males and 9 females. 5 lesions located in sellar region with range from 4 to 63 years median age： 48 years,and 9 lesions located in cerebral and cerebellar hemispheres with range from 2 to 49 years（ median age 19 yrs）. Preoperatively,all patients were misdiagnosed as other diseases. EVN of the sellar region were all solid mass and no abnormality in endocrinal exam. The lesions appeared homogenous isodense on CT,slightly hypointense or isointense on T1 WI and slightly hyperintense or isointense on T2 WI. Calcification（ 40%）,rare cystic necrosis and hemorrhage,and obvious enhancement（ 100%） were a few distinct imaging characteristics. The extent of enhancement was higher than that of choroid plexus of lateral ventricle. EVN of the hemisphere was all cystic-solid mass in which 55. 6% lesions involved frontal lobe. Solid nodule appeared heterogeneous isodense or slightly hyperdense on CT,slightly hypointense or isointense on T1 WI,slightly hyperintense or isointense on T2 WI. Imaging features included necrosis（ 66. 7%） and calcification（ 22. 2%） of the nodule,fibrous septa in cystic area,and well circumscribed（ 88. 9%） with little to no edema（ 66. 7%）. Solid nodule,cystic wall and septations were enhanced. Conclusion Although EVN is a rare neoplasm,it has certain imaging characteristics on CT and MRI. EVN should be considered as a differential diagnosis among patients with solid mass of sellar region in middle aged and elderly patients（ especially with normal endocrine exam） and cystic-solid mass of hemisphere in young adults（ especially in frontal lobe lesions）.
出处
《医学影像学杂志》
2017年第6期1015-1019,1023,共6页
Journal of Medical Imaging
基金
北京市卫生系统高层次卫生技术人才培养计划(编号:2013-3-049)
