中枢神经系统神经上皮囊肿MRI特征及其病理基础

MRI and Pathological Diagnosis of Central Nervous System Neuroepithelical Cyst

目的探讨神经上皮囊肿(NEC)的MRI表现特征及其病理基础。资料与方法回顾性分析15例术前经MRI检查并经手术病理证实的NEC患者的MRI资料,并和蛛网膜囊肿、皮样囊肿、表皮样囊肿及低级别胶质瘤进行对照分析,结合病理重点研究NEC的发生部位、信号特征、强化方式、囊肿周围有无水肿等情况。结果15例NEC中6例位于侧脑室后角及三角区,2例位于脑实质内,1例位于左侧桥小脑角池,3例位于骶管内,3例为脉络膜裂囊肿。MRI确诊率达80%,误诊率为20%。位于脑室、脑池、骶管内者及脉络膜裂囊肿,囊壁菲薄,无壁结节,增强扫描无强化,误诊率低,但有时需与蛛网膜囊肿鉴别;2例位于脑实质内者周围无水肿,增强扫描无强化,但囊内信号复杂,误诊率高,常需与血肿及肿瘤性病变鉴别。结论NEC最常见于侧脑室三角区,其MRI表现有典型特征;而位于脑实质内的NEC罕见,其MRI表现多样,无特征性。

Objective To investigate MRI features of central nervous system neuroepithelial cyst. Materials and Methods 15 patients with neuroepithelial cyst were examined with MRI. Results Among the 15 cases of neuroepithelial cysts, 6 cases located within trigone of lateral ventricles,2 cases in the brain parenchyma, 1 case in left cerebellopontine an- gle cistern and 3 case in sacral canal respectively,3 cases were choroidal fissure cyst. The cysts in ventricles, cictern and sacral canal had characteristic cyst features included thin wall without intramural nodules and peripheral edema. While the cysts in brain parenchyma had no typical cyst sinal and were confused with hematoma or tumor. Conclusion Neuroepithelial cyst most commonly occurred in trigone of lateral ventricles. Neuroepithelial cyst within lateral ventricles showed typical characteristics. MRI was the best tools for diagnosis of Neuroepithelial cyst and could provide instruction for clinical therapy.