侧脑室肿瘤38例MR表现分析

摘要

目的 分析侧脑室肿瘤的MR表现,提高侧脑室肿瘤定性诊断的准确性.方法 回顾性分析第三军医大学新桥医院收治的38例经手术病理证实的侧脑室肿瘤患者的MR征像,扫描序列为T1WI、T2WI、T2 Flair及T1WI增强,包括脑膜瘤、中枢神经细胞瘤、室管膜瘤、室管膜下巨细胞型星形细胞瘤、星形胶质细胞瘤、少突胶质细胞瘤、神经鞘瘤,观察肿瘤发生部位、形态、大小、边界、内部信号、强化程度、邻近脑组织改变等.结果 侧脑室肿瘤的MR表现具有一定的特征性,脑膜瘤(15例)、神经鞘瘤(1例)多发生于侧脑室三角区,信号较均匀,边缘光滑;中枢神经细胞瘤(6例)、室管膜瘤(5例)多见于侧脑室体部,囊变多见;室管膜下巨细胞星形细胞瘤(3例)位于孟氏孔附近,钙化多见;星形胶质细胞瘤(3例)、少突胶质细胞瘤(2例)发生于侧脑室三角区,胶质母细胞瘤(1例)发生于侧脑室前角,各序列信号不均匀,边界欠清晰;脉络丛乳头状瘤(2例)发生于侧脑室三角区,其内可见点状混杂信号,边缘呈颗粒状凹凸不平.增强后脑膜瘤、神经鞘瘤、脉络丛乳头状瘤明显较均匀强化,室管膜下巨细胞星形细胞瘤、星形胶质细胞瘤、少突胶质细胞、胶质母细胞瘤不均匀强化,中枢神经细胞瘤、室管膜瘤轻～中度强化.结论 根据侧脑室肿瘤的MR表现特点,结合肿瘤的发病部位和发病年龄,可提高侧脑室肿瘤定性诊断的准确性.%Objective To analyze MRI features of the lateral ventricle tumors and improve their diagnosis accuracy.Methods Retrospectively analyze the MRI signs of 38 cases of lateral ventricle tumors confirmed pathologically in our hospital,including meningioma,central neurocytomas,ependymomas,subependymal giant cell astrocytoma,oligodendrogliomas,choroid plexus papilloma,glioblastoma and schwannoma.The main scan sequences were T1WI,T2WI,T2 Flair and Gd DTPA contrast enhanced scan.The location,shape,size,border,internal signal,degree of enhancement,adjacent brain tissue changes were observed.Results All kinds of lateral ventricle tumors had their own MRI feature.Both of meningioma(15 cases)and schwannoma(1 case)had homogeneous signal intensity and smooth edges.It was more common for central neurocytomas(6 cases)and ependymomas(5 cases)being in the lateral ventricle and cystic.Subependymal giant cell astrocytoma(3 cases)tends to locate near the foramen of monro and calcify.In contrast,astrocytoma(3 cases)and oligodendroglioma(2 cases)usually were in the lateral ventricle triangle.Glioblastoma(1 case)occurred in the lateral ventricle anterior horn and was of inhomogeneous signal and breezing border.Choroid plexus papilloma(2 cases)often located in the lateral ventricle triangular area and had dot mixed signal and their edge was granular and irregular.In enhanced MRI,meningioma,schwannoma and choroid plexus papilloma usually showed significant and homogeneous enhancement,while subependymal giant cell astrocytoma,astrocytoma,glioblastoma and oligodendroglioma were of heterogeneous enhancement,and central neurocytomas and ependymoma were of mild to moderate enhancement.Conclusion The diagnosis accuracy of lateral ventricle tumor can be improved based on the their MRI features,the location of tumors and the onset age.