脉络丛肿瘤的影像学诊断及鉴别诊断

Imaging Features and Differential Diagnosis of Choroid Plexus Tumors

目的:研究脉络丛肿瘤的影像学表现,探讨其诊断与鉴别诊断。方法:搜集39例经手术病理证实的脉络丛肿瘤,其中脉络丛乳头状瘤35例,脉络丛癌4例。男性13例,女性26例,年龄1～60岁,平均19.5岁。所有病例均行CT和(或)MRI扫描。分析CT和MRI表现。结果:脉络丛肿瘤发生于侧脑室26例,9例位于第四脑室,3例位于桥小脑角,1例同时累及第三脑室和侧脑室。小儿21例,其中2例为脉络丛癌;成人18例,其中2例为脉络丛癌。脉络膜乳头状瘤为良性、分叶状实质性肿块,常见肿瘤血管,可见钙化,出血、囊变很少。实质部分CT呈现等或(和)略高密度;MRI T_1WI呈现等或(和)略高或略低信号,T_2WI等或高信号,FLAIR多为高信号,DWI多为等或略高信号。实质部分常均匀明显增强。无或有极轻微瘤周水肿,一般无脑组织浸润。可致阻塞或(和)交通性脑积水。脉络丛癌可见脑组织浸润或囊变、出血等改变。结论:脉络丛肿瘤具有典型的影像学表现,CT和MRI结合能够做出正确诊断。

Purpose：To study the imaging features of choroid plexus tumors（CPT）,and discuss the diagnosis and differentiation.Methods：Thirty - nine cases of pathological proved choroid plexus tumors（36 papillomas and 3 carcinomas,13 men and 26 women,ranging from 1-60 years old with average 19.5 years old） were enrolled in our study.MRI was performed in 36 cases,of which 33 cases were contrasted;CT was performed in 18 cases,of which 8 cases were contrasted.All the CT and MR images were analyzed. Results：The location of the tumors was in the lateral ventricles in 26 cases,in the fourth ventricle in 9 cases,in the cerebellopontine angle in 3 cases,and in both the third ventricle and the lateral ventricle in 1 case.Twenty - one cases were children and 1 of them was carcinoma,18 cases were adult and 3 of them were carcinoma.Choroid plexus papillomas were lobulated parenchymatous tumors,tumor vessels were usually visible,calcification could be seen,and hemorrhage or cysts were uncommon.On CT images,the tumor were iso - or slightly high - densities;on MRI images,the tumors were iso -,slightly low or high signal intensities on T_1WI,iso - or slightly high signal intensities on T_2WI,high signal intensities on FLAIR,and iso - or slightly high signal intensities on DWI.Markedly homogeneous enhancement could be seen in most cases.Slightly or no peritumoral edema and no infiltration of the brain parenchyma could be seen.Hydrocephalus might be obstructive or communicating.Choroid plexus carcinomas were with infiltration of the brain parenchyma,and with cystic changes or hemorrhage.Conclusion：Choroid plexus tumors had typical imaging features;CT and MRI are valuable in diagnosis,especially MRI.