侧脑室原发肿瘤影像特征与病理对照分析

Imaging features and pathological analysis of primary tumors in lateral ventricle

目的分析侧脑室原发肿瘤的影像特征,增强对侧脑室肿瘤的认识和正确诊断。方法回顾性分析2012-07-2019-06在西南医科大学附属医院经神经外科手术及病理确诊的46例侧脑室原发肿瘤的影像特征,观察病变的位置、大小、CT密度及MRI信号特征、强化方式及与邻近结构的关系,并与病理组织学对照分析。结果46例侧脑室原发肿瘤中,36例为低级别肿瘤(WHOⅠ~Ⅱ级),占78.26%(36/46),脑膜瘤最常见,其次为星形细胞肿瘤;10例为恶性肿瘤(WHOⅢ~Ⅳ级),占21.74%(10/46),胶质母细胞瘤最常见。脑膜瘤均为WHOⅠ级,均位于侧脑室三角区,显著均匀强化为其特征。低级别胶质瘤好发于前角,体积小,壁环状强化;高级别胶质瘤多位于三角区及体部,体积大,易侵犯邻近脑实质,均为花环状强化、不规则结节状强化。中枢神经细胞瘤均位于室间孔区,肿瘤内肥皂泡征及周边囊肿-条索征具有诊断价值。结论肿瘤位置及大小、强化方式和部分肿瘤特征性影像学表现是侧脑室肿瘤诊断和鉴别诊断的重要依据。

Objective To analyze the imaging features of the primary tumors in lateral ventricle and improve its recognition and diagnostic accuracy.Methods The imaging features of 46 cases of primary tumors of lateral ventricle diagnosed by neurosurgery and pathology in the Affiliated Hospital of Southwest Medical University from July 2012 to June 2019 were analyzed retrospectively,including the location,size,CT density,MRI signal characteristics,enhancement mode and relation with adjacent structures,and then compared with histopathology.Results Totally 36 cases were low-grade tumors(WHOⅠ-Ⅱ),accounting for about 78.26%(36/46).Meningioma was the most common tumor,followed by astrocytoma;and 10 cases were malignant tumors(WHOⅢ-Ⅳ),accounting for about 21.74%(10/46),glioblastoma was the most common tumor.Meningiomas were all WHOⅠand located in the triangular area of the lateral ventricle,which were characterized by significant uniform enhancement.Low-grade gliomas occurred in the anterior horn with small size and mild enhancement of the margin.High-grade gliomas were mostly located in the triangular area with big size and invaded adjacent brain parenchyma,accompanied by annular/irregular nodular enhancement.The central nervous cell tumors were all located in the ventricular pore area,and the soap bubble sign in the tumor and the peripheral cyst-strap sign had important diagnostic value.Conclusion The location,size,enhancement pattern and some distinctive imaging features of tumors are important aspects in the diagnosis and differential diagnosis of lateral ventricular tumors.