儿童小脑半球髓母细胞瘤MRI误诊原因分析

Misdiagnostic analysis of medulloblastoma in cerebellar hemisphere of children on MRI

目的探讨儿童小脑半球髓母细胞瘤MRI误诊的原因,提高对髓母细胞瘤的认识。方法手术病理证实的小脑半球髓母细胞瘤8例,回顾性分析其MRI表现及误诊原因。结果3例呈囊性改变,增强扫描可见不规则环形强化,误诊为星形胶质细胞瘤;2例呈囊实性改变,实性部分明显强化,误诊为室管膜瘤;3例呈较均一实性肿块,明显强化,误诊为实性血管母细胞瘤2例、脑膜瘤1例。结论由于不典型的发病部位及MRI表现,儿童小脑半球髓母细胞瘤常易误诊。年龄、信号特点及发病部位对诊断髓母细胞瘤有重要参考价值。

Objective To explore the misdiagnostic reasons of medulloblastoma in cerebellar hemisphere of children on MRI so as to raise the cognition of this disease. Methods The MRI features and misdiagnostic reasons of 8 pediatric patients with surgically and pathologically proved medulloblastoma in cerebellar hemisphere were analyzed retrospectively. Results Among 8 cases, 3 cases whose lesions presented as cystic change with irregular circular enhancement were misdiagnosed as astrocytoma, 2 cases whose lesions presented as cyst-solid change with marked enhancement of solid parts were misdiagnosed as ependymoma, and 3 cases whose lesions presented as homogeneous solid mass with marked enhancement were misdiagnosed as hemangioblastoms（ n = 2）and meningioma（ n = 1 ）, respectively. Condusion Because the locations and MRI findings of this disease are frequently atypical so that it is easily misdiagnosed, however, an overall analysis of age, MRI signal features, and pathologic locations is important reference for correctly diagnosing medulloblastoma in cerebellar hemisphere of children.