不典型颅内海绵状血管瘤的CT、MRI诊断初探

Atypical Intracranial Cavernous Angiomas with CT and MRI:an Initial Study

目的探讨颅内海绵状血管瘤（ICA）的CT和MRI不典型表现。资料与方法回顾性分析经手术病理证实的不典型ICA9例，男5例，女4例，年龄11～72岁，平均35岁。所有病例均行MRI平扫及增强检查，其中4例行CT扫描。结果9例均位于脑内。病灶最大径平均值5．5cm。行CT检查的4例中，2例表现为等、高密度，2例表现为等、低密度；3例病灶内可见钙化。9例T1WI和T2WI呈混杂信号，周围低信号环4例，囊实性病灶5例，囊内见液平面3例，其中囊变伴附壁结节4例，6例出现明显灶周水肿。增强扫描8例呈明显不均匀强化，1例无H月显强化。结论发现瘤体巨大伴有囊性变、瘤体占位效应、病变多种形式的强化等ICA不典型的CT和MRI征象时，应考虑ICA的诊断。

Objective To investigate the CT and MRI findings of atypical intracranial cavernous angiomas（ICA）. Ma- terials and Methods CT and MR findings of 9 cases with atypical cavernous hemangiomas confirmed by surgery and pa- thology were analyzed retrospectively. MRI plain and enhanced scan were performed in 9 cases and CT scan were performed in 5 cases. Results There were intracerebral ICA in 9 cases. The mean values of the maximum diameter of lesions ~ere 5.5 era. Slight hyperdensity were observed in 3 cases,iso-or hypodensity in 2 cases, and calcification in 3 cases in plain CT. Heterogeneous mixed intensity on T1WI or T2WI was observed in 9 cases of ICA,among which hypointensity ring sign in 4 cases. Large eysticosolid changes were found in 5 cases of intracerebral ICA,among which fluid-level sign in 3 cases,nod- ules attachment to the wall in 4 cases,apparent edema around lesions in 6 cases. Apparent heterogeneous enhancement on gadolinium-enhanced T1WI was observed in 8 cases and no enhancement in 1 case. Conclusion Giant lesions with cystic changes,apparent mass-effect,diverse enhancement appearance are atypical CT and MRI findings for ICA. It is feabible to make a correct diagnosis with comprehensive analysis of atypical CT and MRI findings.