中枢神经系统室管膜瘤MRI分析

摘要

目的 探讨颅内及脊髓室管膜瘤的MRI表现,以提高对本病的进一步认识.方法 回顾性分析经手术病理证实的中枢神经系统室管膜瘤53例.结果 53例中,脑室系统15例,其中四脑室11例,侧脑室4例,肿瘤为不规则形或类圆形,边界清楚,T1WI为等信号或略低信号,T2WI为不均匀高信号,瘤周无水肿,增强扫描呈不均匀强化;脑实质14例,其中小脑2例,大脑12例,呈囊性5例、囊实性7例、实性2例,均有囊变,瘤周水肿无或轻微,肿瘤实质部分在T1WI为略低信号,T2WI为高信号,增强扫描实质部分呈轻～中度强化;脊髓内24例,其中颈段8例,胸段6例,腰骶段10例,21例肿瘤边界清楚,T1WI等信号18例,低信号6例,T2WI稍高信号20例,混杂信号4例,增强后7例明显均匀强化,17例肿瘤不均匀强化,16例肿瘤两端可见囊腔.结论 脑及脊髓室管膜肿瘤的MRI具有较特征性表现,有助于该病的鉴别诊断、指导制订治疗方案.%Objective To study MRI diagnosis of intracranial and spinal cord ependymoma, so that to improve the understanding of its imaging findings. Methods 53 cases with ependymomas of central nervous system proved by pathology and surgery were retrospectively analyzed. Results Among the 53 cases with ependymoma,the tumors located at the ventricle in 15, including the fourth ventricle in 11 and lateral ventricle in 4,the tumours showed irregular or like-round masses and well definite,isointense or hypoin-tense on Ti WI and inhomogeneous hyperintense on T2 WI without edema around the tumors and inhomogeneous enhancement on contrast-enhanced images. 14 ependymomas located in the brain parenchyma,including the cerebrum in 12,the cerebellum in 2,the lesions were cystic in 5, solid-cystic in 7, solid in 2 cases, all of them showed cystic changes with slight edema around them or without. The solid parts of the tumors were hypointense signals on TiWI,hyperintense signals on T2WI and showed mild to moderate enhancement on enhanced MR images. The other 24 cases were spinal cord ependymoma,the lesions located in the cervical, thoracic, lumbar and sacral segments in 8,6 and 10, respectively. The tumors were well definite in 21 .isointense in 18,hypointense in 6 on Ti WI, slight-hyperintense in 20 cases and mixed intense in 4 cases on T2WI. After contrast medium administration,? Tumors en-chanced markedly and 17 tumors were heterogeneous enchanced, cystic cavities at both ends to the tumors were seen in 16 cases. Conclusion Intracranial and spinal cord ependymoma show characteristic manifestations on MRI,which is helpful in differential diagnosis and guide treatment plan.