脑内脱髓鞘性假瘤的诊断与治疗(附3例报告)

Diagnosis and treatment of intracranial demyelinating pseudotumors(report of 3 cases)

目的探讨脑内脱髓鞘性假瘤(DPT)的临床表现、影像学特点、病理特征及治疗效果。方法回顾性分析3例DPT的临床资料,并复习相关文献。结果脑内DPT以急性起病为主;影像学多表现为皮质下单一病灶,其强化呈非闭合性、斑片样或垂直于侧脑室分布的火焰样;病理检查发现病灶呈炎性脱髓鞘样改变;皮质类固醇激素治疗后症状均得到明显改善。结论脑内DPT的临床表现与大多颅内肿瘤类似,易误诊为脑胶质瘤;其影像学具有一定的特征性表现;类固醇激素治疗可获得满意疗效。

Objective To explore the clinical manifestation, MR imaging and pathological features and treatment of intracerebral demyelinating pseudotumor （IDPT）. Methods The clinical data of 3 patients with IDPT were analyzed retrospectively. The literatures related to IDPT were reviewed. Results The acute onset in the patiems with IDPT appeared to be more common. IDPTwas commonly single subcortical fous on CT or MRI, and the enhanced open ring-like, or patchy, or flaming-like foci vertical to the cerebral ventricle were observed. The pathological examination showed that IDPT was a typical inflammatory and demyelinating lesion. All the patients were significantly improved in the clinical symptoms after the treatment with eortieosteroid therapy. Conclusions IDPT is similar to some kinds of intraeranial gliomas in the clinical manifestation and is often misdiagnosed as glioma. There are some characteristic findings on CT and MRI in the patients with IDPT. The curative effect of corticosteroid on IDPT was good.