颅内恶性纤维组织细胞瘤的影像学诊断(附10例报告)

Imaging diagnosis of intracranial malignant fibrous histiocytoma(report of 10 cases)

目的:提高影像学对颅内恶性纤维组织细胞瘤的认识。方法:10例均经手术病理证实,术前均经CT检查,其中3例行脑血管造影检查,2例行MRI检查。结果:肿瘤位于额颞顶部、额部、颅中窝、顶部各2例,额顶部、额颞部各1例,CT显示不均匀高密度区或混杂密度区,不均匀强化,2例伴颅骨破坏向颅外生长,MRI(2例)1例T1WI呈等信号,T2WI呈混杂信号;1例T1WI呈低信号,T2WI呈高信号。全部肿瘤边缘呈分叶状。脑血管造影(3例)见大脑前、中动脉受压或弧形移位,可见肿瘤血管显影。结论:对中老年颅脑CT、MRI等影像学表现酷似恶性脑膜瘤、胶质瘤或脑转移瘤者,结合病程短和病情急剧加重,应考虑本肿瘤诊断。

Objective： To improve the level of imaging diagnosis of intracranial malignant fibrous histiocytoma. Methods： Ten cases of malignant fibrous histiocytoma proved by pathology underwent CT examination before operation. Cerebral angiography and MRI were also performed in 3 and 2 cases respectively. Results： The tumor located in the frontoparietotemporal part in 2 cases, in the frontal part in 2 cases, in the middle cranial fossa in 2 cases, in the parietal part of the brain in 2 cases, in the frontoparietal part in 1 case, and in the frontotemporal part in 1 case. Inhomogeneous density and inhomogeneous enhancement were seen on CT with skull bone invasion in 2 cases. On MR, one tumor showed isointense on T1WI and mixed density on T2WI, while the other showed low density on T,WI and high on T2WI. All the tumors were lobulated. Tumor vessels and compression of the anterior and midddle cerebral arteries were seen in cerebral angiography of the 3 cases. Conclusion： The diagnosis of malignant fibrous histocytoma should be considered when its imaging features are similar with those of malignant meningioma, glioma or metastatic encephaloma with a short history and rapid deteriorated course in the middle aged and the old patients.