颅内表皮样囊肿20例

摘要

Objective To study the clinical and cranial MRI features of intracranial epidermal cyst, in order to improve the diagnosis rate. Method The MRI findings of 20 cases of intracranial epidermal cyst were proved by surgery and pathology. All patients underwent conventional plain scan sequence T1WI,T2WI,fluid attenuated inversion recovery sequence (FLAIR) and diffusion weighted imaging (DWI) and gadolinium contrast enhanced scanning (CE-MRI) examination. Results In 20 cases of tumor, 12 cases of cerebral cerebellar angle of the bridge(7 cases of left side, 5 cases of right side).There were 3 cases in front of the bridge,2 cases in the brain parenchyma, (1 case in the right occipital lobe, 1 case in the left frontal lobe, The lesions occurred in the cortex or subcortical areas),1 case in the left side of the left lateral fissure,1 case in the occipital cistern, and 1 case in the fourth ventricle. In which 4 cases were involved in the front pool,the saddle,the side of the pool,the pool and the pool;All lesions were cystic change;13 cases of long T1 and long T2 signal, 4 cases of T1WI, T2WI mixed signal,3 cases of T1WI,T2WI were high signal;11 cases T2FLAIR sequence were examined results showed mixed signal, the number of slightly high signal can be seen,6 cases were low signal,3 cases were slightly high signal;DWI examination results for 19 cases of high signal,1 case of low signal. Conclusion The MRI features of intracranial epidermal cyst are characteristic, In particular,FLAIR and DWI sequences of MRI are helpful in the diagnosis of the disease.%目的：探讨颅内表皮样囊肿（EC）的临床与头颅MRI影像表现，以便提高诊断率。方法经手术病理证实的20例EC的MRI表现。全部患者均进行了常规平扫序列T1WI、T2WI、液体衰减反转恢复序列（FLAIR）及弥散加权成像（DWI）、钆对比剂增强扫描（CE-MRI）检查。结果20例肿瘤脑桥小脑角池12例（左侧7例，右侧5例），桥前池3例，脑实质内2例（右侧枕叶1例，左侧额叶1例，病灶均发生于皮质区或皮质下区），左侧外侧裂池1例，枕大池1例，四脑室1例。其中4例病灶同时受累桥前池、鞍上池、侧裂池及环池等多个脑池间隙；全部病灶均呈囊性改变；13例长T1WI、长T2WI信号，4例T1WI、T2WI为混杂信号，3例T1WI、T2WI均为高信号；11例T2FLAIR序列检查结果均呈混杂信号，其内可见散在的絮状稍高信号影，6例为低信号，3例为稍高信号；DWI序列检查结果为19例高信号，1例低信号。结论 EC的MRI表现具有特征性，尤其是FLAIR及DWI序列MRI表现有助于对该病的明确诊断。