脑膜血管外皮瘤的CT及MRI诊断

CT and MRI diagnosis of meningeal hemangiopericytoma

目的脑膜血管外皮瘤的影像学表现与脑膜瘤相似,鉴别困难。本文通过分析脑膜血管外皮瘤的CT及MRI表现,探讨其影像学特征,以提高对该病的认识。方法搜集经手术、病理证实的9例脑膜血管外皮瘤患者的影像资料,分析其CT与MRI表现。9例均行CT平扫,5例行CT增强,8例行MRI平扫和增强扫描。结果肿瘤位于颅底2例、矢状窦3例、大脑镰旁3例、小脑幕1例;肿瘤直径6～9cm,多呈分叶形或不规则形,少数呈椭圆形或扁圆形,并与脑膜或大脑镰和小脑幕有广基底连接,肿瘤周围有水肿伴占位效应,肿块内见囊变和坏死区,但未见钙化。CT平扫肿瘤呈稍高密度或等密度,有囊变坏死者呈以高密度为主的混杂密度影,3例邻近颅骨有骨质破坏,9例均未见瘤周骨质增生。CT增强扫描,病灶呈均质显著强化,有囊变坏死者强化不均质。MRI平扫,T1WI肿瘤呈等信号,有囊变坏死时呈等低混杂信号,T2WI呈稍高信号或等信号,有囊变坏死者呈等高混杂信号,增强扫描肿瘤显著强化,6例可见"脑膜尾征",有囊变坏死者强化不均质。结论脑膜血管外皮瘤的CT及MRI表现有一定特征性,影像学检查有助于其定位及定性诊断。

Objective Meningeal hemangiopericytoma and meningioma imaging findings similar to identification of difficulties.By analyzing the meningeal hemangiopericytoma CT and MRI of the performance of its imaging features,in order to improve awareness of the disease.Methods Collected by surgery,9 cases of pathologically confirmed patients with meningeal hemangiopericytoma image data,to analyze the CT and MRI.9 patients underwent CT scan,enhanced CT in 5 patients,8 patients underwent plain and enhanced MRI scans.Results The tumor located in the base of the skull in 2 cases,loss of sinus in 3 cases,3 cases of cerebral falx,tentorium in 1 case;tumor diameter 6 ~ 9cm,mostly sub-leaf or irregular shape,small round or flat oval And with the meninges or the cerebral falx and tentorium have broad base connection,with edema around the tumor mass effect,mass within the cystic and necrotic areas,but no calcification.CT scan showed a slightly higher density or other tumor density,deterioration of the deceased was a capsule-based high-density,mixed-density shadow in 3 cases there is bone destruction adjacent to the skull,9 patients showed no peritumoral bone hyperplasia.Enhanced CT scan showed a homogeneous lesion was significantly enhanced,with heterogeneous enhancement capsule worse dead.MRI scan,T1WI showed the tumor signal,there was cystic necrosis,low-mixed signal,T2WI showed a slightly higher signal or other signals,a deterioration of the deceased showed high capsule mixed signals,the tumor was significantly enhanced scan enhancement seen in 6 cases ＂dural tail sign＂,a deterioration of the deceased capsule heterogeneous enhancement.Conclusions Meningeal hemangiopericytoma CT and MRI manifestations of a certain characteristic,imaging contribute to its localization and diagnosis.