颅内血管外皮细胞瘤的MRI／CT影像学表现.pdf

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1、医学影像学杂志2014年第24卷第1O期JMedImagingVol生No．19_14颅内血管外皮细胞瘤的MRI／CT影像学表现许新堂，顾艳，王江涛，苗重昌，周胜利(江苏省连云港市第一人民医院放射科江苏连云港222002)【摘要】目的探讨颅内血管外皮细胞瘤(hemangiopericytoma，HPC)的影像特征。方法回顾性分析经病理及免疫组织化学证实的16例HPC患者的CT及MRI表现。所有患者均行MR扫描，6例行CT扫描。结果所有病变均为单发病灶，均位于颅内脑外，均为分叶状肿块，15例位于幕上，1例位于幕下。6例CT平扫均呈稍高

2、密度、间杂低密度，均未见钙化，1例邻近颅底骨质呈侵蚀破坏，5例增强扫描均呈明显不均匀强化，并可见明显增粗的血管影，4例可见明显的瘤周水肿带。T】wI以等、低信号、TwI以低、高混杂信号为主，2例信号均匀、14例信号不均，13例周围有水肿。增强扫描中15例病灶均明显不均匀强化，1例中度强化。2例病灶与硬膜呈宽基底相连，14例为窄基底相连。16例病灶均未出现“脑膜尾征”。DWI中，7例肿瘤呈等低混杂信号为主。MRS中，4例Cho峰明显升高；2例NAA峰及Cr峰降低。结论HPC影像表现具有一定特点，当脑外肿瘤呈分叶状，内部密度不均匀，有囊

3、变坏死，周围骨质无增生硬化，甚至有破坏吸收改变，水肿较严重，肿瘤内未见钙化，侵犯周围脑组织或并发颅外转移时，提示HPC可能性大。【关键词】血管外皮细胞瘤；体层摄影术，X线计算机；磁共振成像中图分类号：R739．41；R814．42；R445．2文献标识码：A文章编号：1006-9011(2014)10—1680一O4MRI／CTfindingsofintracranialhemangiopericytomaXUXin—tang，GUYan，WANGJiang—tao，MIAOChong—chang，ZHOUSheng—liDepar

4、tmentofRadiology，FirstPeople’SHospitalofLianyungang，Jiangsu222002，P．R．China[Abstract]ObjectiveTosummarizetheimagingfeaturesofhemangiopericytoma(HPC)．Methods16patientswithHPCprovenhistopath0logicallywerecollected．6caseshadCTdataandallcaseshadMRdata，Theimagingfeaturesand

5、pathologicalresultswereretrospectivelyanalyzed．ResultsAllcasesweresinglelesionswithlobulatedshape，aroseOut—sidethebrain．15cases(15／16)weresupratentorialwhile1casewasinfratentoria1．6caseswithplainscanweremanifes—tedashighandlowisodensity，andnonehadcalcification．Smoother

6、osionofthebasicranialskullin1lesion．5caseswereobviousheterogeneousenhancement，andmarkedenlargedvascularimagecouldbeseen．Therewasobviousperilesionale—demain4cases．TherewerelowsignalorequisignalonT1WI，whileT2WIshowedhighandlowsigna1．Thesignalsofthe2caseswerehomogenous，ho

7、wever，thesignalsoftheother14caseswereheterogeneous．In13cases，aroundthelesionswereedemabelt．15caseswereobviousinhomogeneousenhancementinCTenhancementscanning．1casewasmoderateenhancement．2tumorswerebroad—basedduralattachment．14tumorswerenarrow—basedduralattachment．Therew

8、asno”duraltailsign”inall16cases．Mostofsignalsin7casesweremixedwith1OWandiso—intensitybyDWI．Thepeaksofchoin4casesweres