松果体区肿瘤的CT与MRI鉴别诊断

CT and MRI differential diagnosis of pineal recess tumors

目的 :评价松果体区肿瘤的影像学特征。方法 :回顾性收集经手术及病理证实的松果体区肿瘤 2 0例。 9例行CT扫描 ,11例行MR扫描 ,均同时作增强扫描。将该区肿瘤分成为原发性肿瘤和来自邻近结构的肿瘤 ,对其CT与MR影像资料和有关临床资料进行分析。结果 :16例原发性肿瘤中 ,生殖细胞瘤 10例、松果体肿瘤 3例、畸胎瘤 2例、脂肪瘤 1例 ;来自邻近结构的为天幕裂孔动脉瘤、脑膜瘤、蛛网膜囊肿和Galen静脉畸形各 1例。CT平扫 ,生殖细胞瘤、松果体瘤和畸胎瘤表现为分叶状的等密度、高密度或混杂密度肿块 ,可有钙化 ,钙化大小与形态不一 ,畸胎瘤内常含有脂肪、钙化和骨骼。除脂肪瘤外增强后其它原发性肿瘤均可明显强化 ,MRI均表现为长T1和长T2 信号 ,增强后肿瘤均明显强化。结论 :CT与MRI在松果体区肿瘤的诊断中具有重要价值 ,在鉴别诊断中MRI优于CT。

Objective:To evaluate the imaging features of pineal recess tumors.Methods:To analyse the imaging appearances of 20 cases with pineal recess tumors proved surgically and pathologically retrospectively.9 cases were examined with CT,11 cases were examined with MRI.They were classed as primary tumors and tumors near by pineal recess,at the same to analyse imaging CT and MRI features of the tumors and clinical data.Results:mong 16 cases primary tumors,10 cases were germinoma,3 cases were pinealocytoma,2 cases were teratoma,1 case was lipoma;4 cases came near by pineal recess,including tentorium of cerebelum,meningioma,quadrigeminal cistern arachnoid cyst and malformation of Galen vein.Using CT plain scan,the germinoma,pinealoma and teratoma could showed lobulated isodense,hyperdense or heterogeneous dense.Exclusive of lipoma,other tumors had enhanced,but cystic parts had not enhanced.The MRI fingings,the tumors showed long T 1 intensity and long T 2 intensity,they were manifested as hypointensity on T 1WI and hyperintensity on T 2WI,post-contrast,the tumors and metastasis under ependyma were enhanced.Conclusion:CT and MRI play an important role in diagnosis and MRI was better than CT in differential diagnosis.