颅内神经元及混合性神经元肿瘤的临床特征与MRI、CT

Clinical Characteristic and MRI、CT Findings of Intracranial Neuronal and Mixed Neuronal-Glial Tumor

目的:增进对颅内神经元及混合性神经元肿瘤的临床特征与MRI、CT表现的进一步认识。材料和方法:对18例术前误诊而术后病理证实为颅内神经元及混合性神经元肿瘤的临床资料及影像学资料进行回顾性分析。结果:18例病人中节细胞胶质瘤9例 ,术前MRI及CT表现无明显特征性表现 ,分别误诊为胶质瘤 (6例 )、脑膜瘤 (2例 )及颅咽管瘤 (1例 )。胚胎发育不良性神经上皮瘤 (DNTS)4例 ,CT与MRI表现为病变分布大脑皮质 (2例 )同时累及白质 (2例 ) ,病灶呈方形或三角形 ,无占位效应 ,无瘤周水肿 ,MRI示长T1 长T2 信号 ,T2WI有时呈混合信号 ,2例增强后不强化 ,术前误诊为软化灶 (3例 )和胶质瘤 (1例 ) ;多纤维组织婴儿节细胞胶质瘤 (DIG)2例 ,病灶呈囊实性伴钙化 ,术前误诊为髓母细胞瘤和少枝胶质瘤 ;中枢神经细胞瘤3例 ,术前误诊为脑膜瘤和脉络丛乳头状瘤。结论:颅内神经元及混合性神经元肿瘤临床上有一定的特征性 ,影像表现上极易误诊为脑内其他肿瘤 ,需仔细分析影像上某些特征性MRI与CT表现才得以诊断。

Purpose:The goal was to better understand the Clinical characteristic and MRI、CTfindings of intracraˉnial neuronal and mixed neuronal-glial tumor.Materials and Methods:Clinical data and imaging finding in eighteen patients with intracranial neuronal and mixed neuronal-glial tumor confirmed by pathology were retrospectively analysed.Results:The mean syptom in18cases(11male and7female)ranging in age from8～36years(mean ages20.9years)was epilepsy and headache.Nine gangliogliomas which apˉpeared as iso-or low density on CT,Iso-or low signal intensity on T 1 WI and high signal intensity on T 2 WI on MRI,were misdiagnosis as gliomas(6cases),meningioma(2)and cranopharynoma(1)preoperaˉtively.Four dysembryoplastic neuroepithelial tumor(DNTs)which were characteristic finding on MRI or CT were found within cerebral cortex(2)and beneath white matter(2),there were no mass and no periˉtumoral edema,Low signal intensity on T 1 WI and high signal intensity or mixed signal intensity on T 2 WI on MRI,Irregular nonhancement in2cases on enhancement MRI,They were misdiagnosed as cerebral malacoplakia(3)and glioma(1).Two desmoplastic infantile ganglioglioma(DIGs)appeared as solid-cystic mass companied by calcification,which misdiagnosis medullobalstoma and oligodendroglioma.Three cenˉtral neurocytomas misdiagnosed as meningioma and choroids plexus papilloma.Conclusion:Some inˉtracranial and mixed neuronal-glial tumor possess of clinical features and imaging features and it micmics other brain tumor on MRI or CT.It was possible to make a tendency preoperative diagnosis on MRI or CT.