中枢神经细胞瘤的诊断及治疗:7例报道

Diagnosis and treatment of central neurocytoma: A report of 7 cases with review of the literature

目的 :探讨中枢神经细胞瘤的影像学表现、诊断和治疗。方法 :分析2005年1月—2013年3月本院收治的7例中枢神经细胞瘤患者的临床资料,总结手术治疗经验,并对相关文献进行综述。结果 :7例患者中,男性4例,女性3例;6例肿瘤位于侧脑室前2/3,5例起源于室间孔附近的透明隔,1例起源于侧脑室侧壁;头颅MRI平扫T1WI多呈低信号为主的混杂信号,T2WI多呈高信号或稍高信号,增强MRI呈不均匀性强化。肿瘤完全切除6例,次全切除1例;术后放疗2例,化疗1例。术后院内死亡1例。随访时间为15至25个月,随访5例,失访1例。4例患者均预后良好,1例患者偏瘫,均未见肿瘤复发。结论 :显微外科手术是治疗中枢神经细胞瘤的首选方法,掌握手术技巧及注意事项可达到明显的治疗效果,同时可根据患者情况选择术后放疗。

Objective： To analyze the imaging findings, diagnosis and treatment of central neurocytoma. Methods： The clinical information of 7 cases of central neurocytoma in Second Hospital of Hebei Medical University from January 2005 to March 2013 was retrospectively analyzed. The surgical experience was summarized, and the related literatures were reviewed. Results： Of 7 cases, 3 were females and 4 were males; 6 had tumor in anterior 2/3 of the ventricle, 5 originated from septum pellucidum around monro foramen, I originated from lateral ventricular wall. The MRI showed that the lesions were mostly hypointense and displayed mixed signals on TIWl images, mainly hypointense and slightly hyperintense signals on T2Wl images; most of neurocytomas showed heterogeneous enhancement on dynamic contrast-enhanced MRI images. Six cases underwent gross total resection, 1 case underwent subtotal resection. Two cases received postoperative radiotherapy,1 case received adjuvant chemotherapy. One case died postoperatively in hospital. Five cases were followed-up, and I case was lost to follow-up. The follow-up time was from 15 to 25 months. Four cases had satisfying prognosis, 1 case had hemiplegic paralysis, and no cases had recurrent tumor. Conclusion： Microneurosurgery is the best treatment for central neurocytoma, mastering the technique and key points of operation can achieve significant clinical effectiveness and improve the prognosis.