不同部位中枢神经细胞瘤的MRI特点及文献分析

MRI characteristics of central neurocytoma in different locations and related literature review

目的:分析不同部位中枢神经细胞瘤(CNC)的MRI表现,以提高对该病的认识和诊断水平。方法:回顾性分析经手术病理证实的11例不同部位CNC的MRI表现,并结合相关文献分析其MRI特点。结果:11例CNC中,8例位于侧脑室体部,侧脑室显示不同程度脑积水,肿瘤呈类圆形、椭圆形或不规则,实性部分T1WI呈等信号,T2WI呈等或略高信号,DWI呈高信号,瘤体内均见多发大小不等囊变区,增强后实性部分明显强化。1例位于侧脑室三角区,肿瘤沿侧脑室壁生长,T1WI呈不均匀低信号,T2WI呈不均匀高信号夹杂条状低信号影,DWI呈低信号,增强呈不规则环状强化。2例脑室外CNC,1例位于额叶,1例位于丘脑,肿瘤形态不规则、边界不清,T1WI呈不均匀低信号夹杂片状稍高信号,T2WI呈不均匀高信号夹杂多发低信号,轻度瘤周水肿,增强呈不均匀片状强化。结论:位于侧脑室体部CNC的MRI表现有一定特点,结合其好发部位、发病年龄,术前多能够做出正确诊断;而其它部位CNC的MRI表现缺乏特异性,术前诊断困难,需依靠病理及免疫组化确诊。

Objective：To study the MRI features of the central neurocytoma （CNC） in different locations to reach a further neuroradiologic understanding of the disease. Methods： MRI findings in 11 cases with pathologically-proved CNC were retrospectively reviewed with reference to related literature. Results：The lesions were located at the lateral ventricular body in eight of 11 cases,and the lateral ventricles presented somewhat hydrocephalus. The tumors was round,elliptic or ir-regular. Solid component of the tumor was isointense on T1WI,isointense or slightly hyperintense on T2 WI, and hyperin-tense on DWI while multiple cystic degenerations in various sizes within the tumor were detected in all cases. Solid compo-nent demonstrated remarkable enhancement. The lesion was located in the trigone of lateral ventricle in one case. It was ir-regular along the ventricular wall and heterogeneously hypointense on T1 WI, hyperintense with stripy low signal on T2 WI, and hypointense on DWI with marked irregularly circular enhancement. There were 2 cases with lesions located beyond the ventricles. One of the two lesions was located in the frontal lobe, the other one lesion was located in the thalamus. Irregular shape, mixed signal, cystic changes, and hemorrhage within the tumor were revealed. Mild perifocal edema and markedly in-homogeneous patchy enhancement were also demonstrated. Conclusion.. CNC located at ventricular body has some typical MRI features which are helpful in making correct pre-operative diagnosis in most cases combining with usual sites and pa- tient age. However,the manifestations in other locations are short of peculiarities resulting in that the correct preoperative diagnosis is not easy to be established,and the final diagnosis may depend on pathology and immunohistochemistry.