颅内皮样囊肿破裂的临床及MRI影像学分析

摘要

Objective To summarize the clinical and MRI features of ruptured intracranial dermoid cysts to improve its diagnosis.Methods Totally 6 patients with ruptured intracranial dermoid cyst confirmed pathologically from March 2005 to April 2016 had their clinical and MRI data analyzed and compared on lesion location,morphology,size,growth and MRI features.Results All the 6 patients had solitary cysts,of which,there were 3 ones in the parasellar region,2 ones in anterior cranial fossa and 1 case in posterior fossa fourth ventricle.MRI showed non-uniform signals in the 6 patients,of whom,4 ones had short T1,long T2 signals,2 ones had long T1,long T2 signals intermixed with short T1,short T2 dot signals.The 2 patients with long T1,long T2 signals had grainy appearance,one of whom showed fat-fluid level and had low signals such as short T1 signals of the fat droplet adjacent to the cerebral sulcus and fat saturation images.Enhancement scanning found 2 cases of minimal peripheral contrast enhancement,1 of whom showed epedyma enhancement.Conclusion The clinical and MRI features of ruptured intracranial dermoid cyst are characteristic,and MRI is of significance for its diagnosis and differential diagnosis.%目的:总结颅内皮样囊肿破裂的临床及MRI影像学特征,提高对该病的诊断水平.方法:收集2005年3月至2016年4月经手术病理证实的6例颅内皮样囊肿破裂的临床及影像学资料,对病灶部位、形态、大小、生长状态、MRI影像学特征进行综合比较分析.结果:6例皮样囊肿均为单发,其中鞍旁3例,前颅窝底2例,后颅窝四脑室1例.病变在MRI上信号不均匀,4例呈短T1长T2信号,2例呈长T1长T2信号,其内夹杂点状短T1短T2信号,颗粒感强,其中1例可见脂液平面,邻近脑沟均见短Tm信号脂滴,压脂像短T1信号,均被抑制呈低信号;增强扫描2例病灶周边轻微强化,其中1例室管膜强化.结论:颅内皮样囊肿破裂临床和影像表现有特征性,且MRI对该病的诊断及鉴别诊断具有重要价值.