摘要
目的为提高对颞骨内淋巴囊肿瘤该罕见疾病的正确诊断率,分析其CT及MRI影像特征和病理基础。方法对7例颞骨内淋巴囊肿瘤的影像学特征、病理变化及鉴别诊断要点进行归纳整理。结果颞骨内淋巴囊肿瘤在影像上表现为血供丰富的分叶状肿块,呈膨胀性生长,病变中心位于颞骨岩部中后缘。影像特征:CT平扫示7例肿瘤均呈分叶状改变,周围骨质呈虫蚀样破坏,病变位于颞骨岩部靠近后缘,瘤内可见“沙粒状”高密度影,部分病变边缘可见弧形高密度硬化边。MRI示3例肿瘤T_(2)WI呈高信影,其内信号混杂可见斑片状短T_(2)信号影,并可见粗细不均条状和带状双低信号影;3例肿瘤在T_(1)WI上可见高信号影,其内信号混杂;1例肿瘤呈等信号,病变边缘可见T_(1)WI高信号影,6例肿瘤在DWI扩散不受限呈低信号影。增强扫描6例肿瘤呈不均匀明显强化;在MRI上双高信号影DWI仍为高信号、双低信号影增强扫描明显强化为其特征性改变。病理特征:肿瘤内成分混杂,肿瘤间质血管丰富,表面覆以乳头状、柱状上皮,局部可见胶质样基质、陈旧性出血等。免疫组化示Vimentin和CK阳性有定性价值。结论CT、MRI结合病例对照研究,反映了颞骨内淋巴囊肿瘤影像特征及病理基础,为临床降低误诊率、术前评价及预后评估提供影像依据。
Objective To retrospectively analyze the CT and MRI imaging characteristics and pathological features of Endolymphatic sactumor(ELST),so as to improve the correct diagnosis rate of this rare tumor.Methods Summarized the imaging features,pathology and differential diagnosis of 7 cases of ELST in our hospital.Results ELST is a lobulated mass with abundant blood supply and expansive growth,and the lesion center is located at the middle and posterior margin of the petros of the temporal bone.Imaging features:CT showed that the tumors in all 7 cases were lobulated with insect-like destruction of the surrounding bones.The lesions were located in the middle of the posterior margin of the temporal bone rock,and "sand granular" high-density shadows were visible inside the tumors with curved sclerotic edges.MRI showed mixed high-signal images on T_(2)WI in 3 cases,and double low-signal images with uneven thickness and strip were seen.The mixed signals of T_(1)WI in 3 cases were mainly high and slightly high.In 1 case,the tumor showed equal signal,and T_(1)WI high signal shadow was seen at the lesion margin.6 cases with unrestricted DWI showed low signal and slightly low signal change.The enhanced scan showed that the lesions showed uneven enhancement in 6 cases.On MRI,T_(1) and T_(2) double high signal,DWI is still high signal;The double low signal enhancement scan is obviously enhanced as its characteristic change.Pathological features:Pathological features:Parenchymal tumor cells were papillary or glandular,covered by columnar epithelium,with abundant interstitial blood vessels and local glial matrix.Immunohistochemistry showed that Vimentin and CK were positive with qualitative value.Conclusion CT,MRI combined with pathological control study,reflectes the imaging features and pathological basis of ELST,and provides imaging basis for reducing misdiagnosis rate,preoperative evaluation and prognosis evaluation.
作者
袁逍
贺延莉
李玮
李燕燕
刘楠
赵海燕
鲍花
马冯慧
YUAN Xiao;HE Yan-li;LI Wei;LI Yan-yan;LIU Nan;ZHAO Hai-yan;BAO Hua;MA Feng-Hui(Department of Radiology,Tangdu Hospital,Air Force Medical University,Xi'an 710038,Shanxi Province,China;Department of Health Management physical examination center,Tangdu Hospital,Air Force Medical University,Xi'an 710038,Shanxi Province,China)
出处
《中国CT和MRI杂志》
2024年第6期4-6,共3页
Chinese Journal of CT and MRI
