松果体细胞瘤的CT、MRI影像学表现分析

摘要

目的:对松果体细胞瘤影像表现进行分析,并与松果体区其他病变进行鉴别,提高诊断准确率.方法:收集6例经手术和病理证实的松果体细胞瘤患者的临床病史、CT及MRI影像学资料,对病灶形态、囊实性改变程度、是否有坏死、是否合并出血和/或钙化、实性成分的MRI平扫及增强扫描强化方式,病灶周边脑组织水肿情况、是否合并脑积水等指标进行综合比较分析.结果:平扫1例病灶呈实性,5例呈实性为主的囊实性结节;2例病灶境界清晰,4例病灶境界欠清;4例病灶有明显脑积水表现,2例患者呈轻度脑积水表现,增强后扫描除1例未见明显强化,余均表现为中度或明显不均匀强化.1例病灶CT检查示内部钙化灶,1例病灶CT检查示病灶出血.结论:松果体细胞瘤影像学比较符合良性肿瘤特征,当病灶较大挤压周围脑实质或堵塞中脑导水管进而产生明显临床症状时,应注意与好发于此区的其他肿瘤鉴别.%Objective To improve diagnosis accuracy of pineocytoma (PC) by joint analysis of CT,MRI imaging features and differential diagnosis with other lesions in pineal region.Methods Totally 6 pineocytoma patients confirmed surgically and pathologically had their clinical history,CT and MRI data collected and analyzed on lesion morphology,cystic solid changes,existence of necrosis,complications of hemorrhage and or calcification,MRI and enhanced scan of solid component,complications with hydrocephalus and etc.Results Plain scan found 1 case of solid nodule and 5 cases of cystic-solid nodules,2 cases with clearly-bordered lesions and 4 one not as well as 4 cases with significant hydrocephalus and 2 ones with light hydrocephalus.Enhanced scan showed 5 cases of moderate to marked enhancement and one case with no obvious enhancement.CT examination proved there were 1 case of calcification and 1 case of hemorrhage.Conclusion Pineocytoma has the characteristics of benign tumor,and has to be differentiated with other tumors frequently occurring in this region in case of obvious clinical signs due to crushing brain parenchyma or blocking aqueduct cerebri by oversized lesions.