中枢神经系统伸长细胞型室管膜瘤的MR I表现

摘要

目的：探讨中枢神经系统伸长细胞型室管膜瘤(TE)的 MRI表现,提高对其病理亚型的进一步认识。方法回顾性分析经手术病理证实的TE 26例,观察肿块发生的部位、大小、内部的信号特点、有无囊变、出血、“帽”征、脊髓空洞、水肿、有无种植转移及增强扫描后的强化特点等。结果26例中,幕上2例均位于左侧额叶,呈大囊小结节结构,与左侧脑室相通,囊内呈均匀脑脊液信号,结节均呈等T1稍短T2信号,增强扫描结节明显强化。椎管内24例,颈段及颈胸段肿瘤16例,1例为囊性肿块,可见出血液-液平面,余均为实性肿块,呈等T1、等或稍长T2信号,4例中心短T2出血信号,囊变常见,6例可见“帽”征,增强后12例边界清晰,大部分中等程度强化,13例有空洞形成,1例有延髓及小脑播散。胸腰段及腰段肿瘤8例,等T1、等或稍长T2信号,其中4例病灶中心有陈旧出血信号,3例病灶边缘小圆形囊变,1例病灶伴空洞,未见“帽”征,增强后呈中等强化。结论脑及脊髓内 TE 的MRI具有一定特征性表现,有助于术前诊断及指导临床治疗。%Objective To study MRI features of tanycytic ependymoma (TE)in central nervous system,to improve the further understanding of this rare tumor.Methods 26 cases with TE of central nervous system proved by pathology and surgery were analyzed retrospectively in terms of location,size,signal intensity,the presence or absence cyst,hemorrhage,“cap sign”,syringes,edema, implantation metastasis and enhancement pattern etc.Results In 26 cases,2 cases were located in the left frontal lobe,with macro-cyst and micro-nodules,and the left ventricle was interlinked.The signal of cystic region was similar to CSF,and nodule-regions were a bit iso-intensity signal on T1 WI and hypo-intensity on T2 WI with significantly enhanced.The other 24 cases were located in the spinal cord,in which 1 6 cases were in the cervical and thoracic cord.1 case of cystic masses had hemorrhagic fluid level,the others were solid masses with iso-intensity signal on T1 WI and iso or bit hyper-intensity signal on T2 WI,in which 4 cases with hypo-intensity signal on T2 WI and cystic were seen frequently,cystic were common,and 6 cases with “cap sign”.Most of masses were medium enhanced and 1 2 cases were well-defined.1 3 cases with syringomyelia and 1 case with the medulla oblongata and cerebellum implantation.The lesions located in thoracic and lumbar cord in 8 cases with iso-intensity signal on T1 WI and iso or bit hyper-intensity signal on T2 WI, in which 4 cases were hypo-intensity signal on T2 WI,and 3 cases showed small round cystic changes,and 1 case showed syringomyelia and no “cap sign”.8 cases were medium enhanced.Conclusion TE in central nervous system shows characteristic manifestations on MRI,which are helpful in differential diagnosis and guide for treatment.