开环状强化对脱髓鞘性假瘤的诊断价值

Open-ring enhancement sign in diagnosing demyelinating pseudotumor

目的分析脱髓鞘性假瘤的增强MRI表现,探讨开环状强化征象对该病的诊断价值。方法脱髓鞘性假瘤患者14例及脑内星形细胞瘤患者21例,回顾性分析其增强MRI表现特点,并复习相关临床及文献资料。结果 14例脱髓鞘性假瘤中6例脱髓鞘性假瘤患者增强MRI显示病变呈开环状强化,2例呈完整环形强化改变,3例病灶明显结节样强化,1例呈斑片样强化,1例轻微强化,1例强化不明显。21例星形细胞瘤中,6例未见明确强化改变,2例可见斑片状强化,13例呈完整环形或花边样强化;均未显示开环状强化。结论脱髓鞘性假瘤的开环状强化改变有比较典型的特点,对脱髓鞘性假瘤的诊断有重要价值,是鉴别脑内脱髓鞘性假瘤、星形细胞瘤的重要依据。

Objective To describe open-ring enhancement sign on MRI of demyelinating pseudotumor. Methods Contrast-enhanced MRI of histologically confirmed demyelinating pseudotumors （14 patients） and astrocytomas （21） was reviewed. Results Of the 14 cases of demyelinating pseudotumor, open-ring enhancement pattern was observed in 6; closed ring enhancement in 2; nodular enhancement in 3; patchy enhancement in 1; slight enhancement in 1; and no enhancement in 1. Of the 21 cases of astrecytoma, there was complete ring or lace-like enhancement in 13, no contrast enhancement in 6, patchy enhancement in 2, and none with open-ring enhancement pattern. Conclusion Open-ring enhancement is a valuable sign in differential diagnosis between demyelinating pseudotumor and astrocytoma.