脑肿瘤卒中的发病机制与MRI表现

Pathogenesis and MRI features of stroke due to brain tumor

目的提高对脑肿瘤卒中MRI特点的认识。方法分析对照21例33个脑肿瘤卒中病灶和28例单纯性脑内血肿的MR表现,观察血肿的MR信号、周围水肿、含铁血黄素沉积圈和增强表现。结果33个脑肿瘤卒中MR信号不均匀25个(75.6%),周围水肿持续存在33个(100%)、水肿范围扩大26个(78.8%),含铁血黄素沉积圈不规则、离散、零乱、厚度不均匀28个(84.8%),增强扫描31个病灶内可见强化影(93.9%)。而单纯性脑内血肿的MR信号有一定的规律性,周围水肿在慢性期后减少或消失,含铁血黄素沉积圈规则、完整、厚度均匀,增强扫描表现为急性期无强化,亚急性期、慢性期呈环状强化。结论脑肿瘤卒中血肿的MR信号、周围水肿、含铁血黄素沉积圈以及增强扫描表现具有特征性,可以作为其诊断依据。

Objective To make better known of MRI features of stroke due to braintumor. Methods 21 cases with 33 stroke lesions due to brain tumor and 28 cases withsimple brain hematoma were reviewed for MR signals, surrounding edema, hemosiderinrim and enhancement in the hematomas. Results Of the 33 MR signals in stroke dueto brain tumor, 25(75.6%) were uneven, 33(100%) were with persistent edema, 26(78.8%) showed enlarged edema scope, 28(84.8%) manifested hemosiderin rim irregular,discrete, random and uneven thickness, and 31(93.9%) presented enhanced shadow. Incontrast, MR signals of simple hematoma were regular, edema surrounding the hematomafaded or disappeared posterior to the chronic stage, the hemosiderin rims were regular,complete, even in thickness, displaying no enhancement in acute stage and rim-shapedenhancement in subacute and chronic stage. Conclusion It is characteristic for imagesof stroke due to brain tumor in MR signal, surrounding edema, hemosiderin rim andenhanced scan. The characteristics contribute to diagnosis.[