海绵窦海绵状血管瘤的MRI特征

Magnetic Resonance Imaging Features of Cavernous Sinus Cavernous Angioma

目的:分析颅内海绵窦海绵状血管瘤的MRI特征,以提高对本病的认识。方法:回顾分析我院经手术和病理证实的海绵窦海绵状血管瘤25例(7例男性,18例女性;平均年龄50.6岁,范围28～74岁)。采用1.5T或3.0T超导系统(GESigna)MRI检查,包括T1WI、T2WI和增强后T1WI扫描。结果:病灶大小2.5～6cm(平均4.30cm),右侧17例,左侧8例。T1WI上24例病灶相对于白质呈低信号,仅1例呈高信号。T2WI上22例呈显著高信号,2例呈混杂信号,1例呈显著高信号伴部分流空信号。注射对比剂后10例呈显著均匀强化,其余15例呈显著不均匀强化。不均匀强化者均表现为增强扫描第二时相强化范围扩大。16例为累及鞍内的横向不对称哑铃形肿块,7例为球形肿块(其中2例可见小部分伸入鞍内),2例为分叶状肿块累及鞍旁和鞍内。所有病例均不伴邻近颞叶脑组织水肿,颈内动脉被推移或包绕。结论:海绵窦海绵状血管瘤多见于中老年女性,MRI特征为鞍旁肿块或鞍旁累及鞍内的肿块,呈横向哑铃形或球形,境界清楚,T2WI呈显著高信号;增强后病灶呈显著均匀强化或不均匀进行性强化。

Purpose：The aim of this article is to analyze the MRI features of cavernous angiomaes located in the cavernous sinus,to promote our understanding of this disease.Methods：Twenty-five patients（7 men and 18 women; mean age 50.6 years; range 28-74 years） with surgically and pathologically verified cavernous angiomaes in the cavernous sinus were reviewed. MRI scans including T1-weighted,T2-weighted,and postcontraste T1-weighted imaging were carried out with 1.5-T or 3.0-T superconductive system （Signa; General Electric Medical Systems,Milwaukee,WI）.Results：All these lesions measured from 2.5cm to 6cm （average,4.3cm）included 17 lesions located to the right side and 8 to the left side. Magnetic resonance images showed that 24 cases were hypointense to white matter on T1-weighted images,only one case showed mixed hypointensity and hyperintensity. On T2-weighted images,22 cases showed marked homogeneous hyperintensity,2 cases with mixed intensity and 1 showed marked hyperintensity with some signal void structures. Marked homogeneous enhancement after contrast material administration was found in 10 cases,and marked heterogeneous enhancement in 15,these 15 lesions were further enhanced on the second phase. Asymmetrical dumbbell-shaped masses of 16 cases involving the sellar,round masses of 7 cases with 2 protruding into the sellar and 2 lobulated masses involving the sellar were found. All of the cavernous angiomaes displaced the adjacent temporal lobe without adjacent brain edema. The internal carotid arteries were displaced or encased in all cases. Conclusion：Cavernous sinus cavernous angiomaes are well-demarcated dumbbell or round lesions involving both parasellar and sellar regions. The MRI features of them are homogeneous high signal intensity on T2-weighted images with marked homogeneous or progressive heterogeneous enhancement.