中枢神经系统血管外皮细胞瘤的CT、MRI表现与病理分析

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目的探讨中枢神经系统血管外皮细胞瘤的MRI及CT影像学特点,以提高诊断水平。方法回顾性分析经手术病理证实的中枢神经系统血管外皮细胞瘤11例。9例行MRI平扫及增强,4例行CT平扫,3例增强。结果 8例位于颅内脑外,1例位于侧脑室三角区内,2例位于髓外硬膜内;5例呈类圆形或椭圆形结节、肿块(45.5%),5例(45.5%)呈分叶状肿块,1例形态不规则;CT上,4例均为高密度肿块,2例伴坏死,1例伴钙化,增强后3例均明显强化,2例伴脑膜增厚强化。MRI上,6例(66.7%)呈与脑白质等信号的稍短T1信号,2例呈与灰质等信号的等T1信号,1例呈稍长T1信号;T2WI上,8例(88.9%)呈与灰质等信号的T2信号,1例呈稍长T2信号;6例(66.7%)伴囊变;8例(88.9%)与脑膜或脊膜相连,6例(66.7%)以宽基底相连,2例(22.2%)以窄基底相连;5例(55.6%)伴流空血管;增强后9例均明显强化,囊变坏死无强化,8例(88.9%)邻近硬脑膜或脊膜均增厚、强化,4例(44.4%)见典型“脑膜尾征”;8例(88.9%)颅内病灶伴水肿。3例伴骨质破坏。结论中枢神经系统血管外皮细胞瘤具有一定的CT、MRI特征性,最终诊断依靠病理。 Objective To explore the features of MRI and CT imaging of central nervous system hemangiopericytoma in order to improve the diagnostic level. Methods Retrospective analysis of 11 cases of central nervous system hemangiopericytoma confirmed by surgery and pathology. 9 cases of MRI plain and enhanced, 4 cases of CT plain scan, 3 cases enhanced. Results Eight patients were located in the intracranial brain, one in the lateral ventricle trigone and two in the extramedullary dura. Five patients had round or oval nodules, masses (45.5%) and five patients (45.5% ) Showed a lobulated tumor, 1 case of irregular shape; CT, 4 cases were high-density mass, 2 cases with necrosis, 1 case with calcification, enhanced 3 cases were significantly enhanced, 2 cases with meningeal thickening. Six patients (66.7%) showed T1 signal on the MRI, two T1 signals on the gray matter and two T1 signals on the MRI. One patient had a slightly longer T1 signal. On the T2WI, 8 patients (88.9% Six patients (66.7%) had cystic degeneration, eight patients (88.9%) were connected with the meningeal or meningioma, and six patients (66.7%) were connected with a wide basement (22.2%) were connected with a narrow base. Five patients (55.6%) had empty vessels with blood vessels. All of the 9 cases were significantly enhanced after cystadenocarcinoma enhancement and cystic degeneration and necrosis did not develop. Eight cases (88.9% Thickened, enhanced, 4 cases (44.4%) See typical “Meningeal sign ”; 8 cases (88.9%) with intracranial lesions associated with edema. 3 cases with bone destruction. Conclusion The central nervous system hemangiopericytoma has certain CT and MRI features, and the final diagnosis depends on the pathology.
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