下丘脑错构瘤的CT和MRI诊断

CT and MRI imaging of hypothalamic hamartoma

目的 :研究下丘脑错构瘤的CT和MRI影像表现 ,探讨影像学、临床及预后的关系。方法 :分析 2例下丘脑错构瘤的CT和MRI资料。其中男 1例 ,女 1例 ,年龄 1.5～ 2岁。 1例行CT平扫和增强 ,另 1例行MRI平扫和增强 ,又作了CT平扫。 2例均经手术和病理证实。结果 :全部病例临床表现主要为性早熟和痴笑样癫痫。肿块与灰结节或乳头体相连 ,CT表现为与皮质等密度的不增强肿块。MRI表现在T1WI上与灰质等信号 ,在PDW和T2 WI上等信号或轻度高信号 ,肿块不增强。结论 :如患儿临床上表现为性早熟和痴笑样癫痫 ,影像学上显示灰结节或乳头体肿块 ,具有典型CT和MRI表现 ,应首先考虑本病。本病应与颅咽管瘤、下丘脑胶质瘤、生殖细胞瘤鉴别。

Objective:To study the CT and MRI findings of hypothalamic hamatomas and evaluate the correlation of imaging features, clinical symptoms and prognosis.Methods:CT and MRI findings of 2 patients with hypothalamic hamartomas were analyzed.The patients included male one and female one,aged from 1.5 to 2 years.One was performed plain and enchanced CT scanning,and the other plain and enchanced MRI as well as plain CT scanning.All was proved by surgery and pathology.Results:All patients presented as precocious puberty or gelasmus epilepsy.The mass was closely related to the tuber cinereum or the mammillary body and appeared isodense to cortex but not enhanced on CT scans.On MRI,the mass was isointense to graymatter on T 1WI and isointense or slightly hyperintense on PDW and T 2WI, and not enhanced after Gd DTPA injection.Conclusion:If a child suffered from precocious puberty or gelasmus epilepsy,together with CT and MRI characteristics of the mass near the tuber cinereum or mammillary body,the diagnosis of hypothalamic hamartoma might be considered first.It should be differentiated from craniopharyngioma,hypothalamic glioma or germinoma.