【摘要】：目的探討小腦延髓池腫瘤的MRI診斷價(jià)值。方法對(duì)17例經(jīng)手術(shù)病理證實(shí)的小腦延髓池腫瘤的MRI表現(xiàn)進(jìn)行回顧性分析。所有病例均采用3.0 T MR掃描儀平掃加增強(qiáng)掃描,并行橫斷位、矢狀位、冠狀位重組,分析腫瘤部位、與周圍組織的關(guān)系及MRI特征。結(jié)果本組中神經(jīng)鞘瘤4例,腫瘤貼附于延髓背側(cè)呈偏側(cè)性生長,囊變明顯,增強(qiáng)囊壁及實(shí)性部分明顯強(qiáng)化;室管膜瘤3例,腫瘤定位于小腦延髓池,形態(tài)不規(guī)則并有囊變,可見腦脊液環(huán)繞,增強(qiáng)實(shí)性部分輕至中度強(qiáng)化;腦膜瘤3例,均為寬基底的實(shí)性腫塊,增強(qiáng)均勻明顯強(qiáng)化,其中1例見"腦膜尾征";血管母細(xì)胞瘤3例,2例表現(xiàn)為"大囊小結(jié)節(jié)";1例瘤體為實(shí)性腫塊,增強(qiáng)后明顯強(qiáng)化,瘤周可見粗大供血?jiǎng)用};脈絡(luò)叢乳頭狀瘤2例,為小腦延髓池內(nèi)淺分葉狀的腫塊,周圍見腦脊液環(huán)繞,信號(hào)稍不均勻,增強(qiáng)均見明顯強(qiáng)化,1例見微囊變;膠質(zhì)母細(xì)胞瘤1例,腫瘤來源于小腦半球并突向小腦延髓池,信號(hào)不均勻,見多發(fā)囊變及周圍腦組織水腫,增強(qiáng)后呈"花環(huán)"狀強(qiáng)化;脂肪瘤1例,T1WI、T2WI均呈高信號(hào),脂肪抑制呈低信號(hào),邊界清晰,增強(qiáng)掃描強(qiáng)化不明顯。結(jié)論小腦延髓池腫瘤的MRI表現(xiàn)各有其特點(diǎn),通過MRI檢查能精確定位,有助于推斷腫瘤的來源,并根據(jù)信號(hào)特點(diǎn)進(jìn)行定性診斷。
[Abstract]:Objective to investigate the value of MRI in the diagnosis of cerebellar medullary cistern tumors. Methods MRI findings of 17 cases of cerebellar medullary cistern tumors confirmed by operation and pathology were retrospectively analyzed. All cases were examined with 3. 0T Mr scan with plain scan and enhanced scan, and then were reconstructed in transverse, sagittal and coronal position. The relationship between tumor location and surrounding tissues and MRI features were analyzed. Results in 4 cases of neurilemmoma, the tumor was attached to the dorsal side of the medulla oblongata, with obvious cystic change, enhanced cystic wall and solid enhancement, and ependymoma in 3 cases, the tumor was located in the medullary cistern of cerebellum oblongata with irregular morphology and cystic degeneration. All cases of meningioma were solid masses with wide base, and the enhancement was even and obvious, and the enhancement was moderate to moderate in the surrounding cerebrospinal fluid (CSF), 3 cases of meningioma were all solid masses with a wide base, and the enhancement was even and obvious. "meningeal tail sign" was seen in 1 case, hemangioblastoma in 2 cases presented as "big cystic nodule" (1 case) as solid mass, enhanced obviously after enhancement, and large supply artery around the tumor, choroidal plexus papilloma (2 cases), and choroidal plexus papilloma (2 cases). It was a superficial lobular mass in the cerebellar medullary cistern, surrounded by cerebrospinal fluid (CSF), slightly uneven in signal intensity, obviously enhanced in 1 case, microencapsulated in 1 case, glioblastoma in 1 case, the tumor originated from the cerebellar hemisphere and protruded to the cerebellar medulla cistern. The signal intensity was not uniform, multiple cystic changes and edema of peripheral brain tissue were observed, and enhanced with "rosette" enhancement, 1 case of lipoma showed high signal intensity on T _ 1WI ~ (I) T _ 2WI, low signal intensity on fat suppression, clear boundary, and no obvious enhancement on enhanced scan. Conclusion the MRI findings of cerebellar medullary cistern tumors have their own characteristics. The accurate location of the tumors can be determined by MRI, which is helpful to infer the origin of tumors and to make qualitative diagnosis according to the signal characteristics.
【作者單位】： 福建省龍巖市第二醫(yī)院放射科;中山大學(xué)附屬第一醫(yī)院放射科;
【分類號(hào)】：R739.41;R445.2

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