目的 探讨脑脱髓鞘假瘤的磁共振影像学特征与临床病理的关系.方法 搜集经病理证实的脑脱髓鞘假瘤3例,结合文献复习其MR形态及信号特点,并与病理及临床症状对照.结果 本组3例(男2例,女1例)患者发病年龄24～68岁,发病前无明确的前驱感染史或诱因,3例患者中,其中2例为单发,1例位于双额叶,1例位于右颞叶,另1例为颅内多发病灶,MRI T2WI呈稍低信号,T1WI呈低信号为主,增强后呈半环形或斑片状强化,其中1例合并出血性改变,病理上表现为典型脱髓鞘、炎性浸润及反应性细胞增多,多数可见具有核分裂状的肥胖型胶质细胞.结论 颅内炎性脱髓鞘假瘤的MRI影像学表现具有一定的特点,增强扫描及扩散加权技术有助于脱髓鞘假瘤的诊断及鉴别诊断.%Objective To evaluate imaging features of brain demyelinating pseudotumors (DPT) and correlation with clinical pathological finding. Methods The MR imaging features of 3 patients confirmed by bioscopy were analyzed, the correlation of imaging features with clinical pathological findings were evaluated and reviewed the MRI features of relevant literature. Results 3 cases (2 males and 1 female) with DPT were analyzed, aged 24 to 68 years old. There was no definite antecedent and the clinical syndromes were atypical. 2 of 3 cases showed solitary lesions in cerebral frontal lobe and temporal lobe respectively, and 1 case showed multiple lesions in cerebral hemisphere. On T2WI, the lesions showed low-density or isodensity, and on T1 WI the lesions showed low density. The lesions appeared half-round and patch enhancement on MR contrast- enhancement scan, and 1 case appeared slight hemorrhage around the lesions. All patients with diffusion weighted imaging (DWD showed high density. The typical pathological changes were demyelination, perivascular inflammatory infiltration and reactive gliosis. The cteutzfeuldt cells could be found in most patients. Conclusion DPT has some characteristic MRI imaging features, most of the lesions occurred in or near the cerebral superficies of white mater, contrast enhancement MRI and diffusion weighted imaging(DWI) were useful technique in the DPT diagnosis and differential diagnosis with other tumors.
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