幕上脑内单发环形病变CT诊断

CT Diagnosis of Supratentorial Intracerebral Solitary Circular Lesions

目的 探讨CT扫描对幕上脑内单发环形病变的诊断价值。材料与方法 复习经手术及病理证实的幕上脑内单发环形病变 5 8例的CT扫描资料 ,包括星形细胞来源肿瘤 19例 ,室管膜瘤 4例 ,脑转移瘤 18例 ,海绵状血管瘤 1例 ,脑脓肿 16例。结果 幕上单发环形病变因病理基础不同 ,出现相似和不同的CT征象 ;病变部位、形态、强化程度对诊断有一定价值 ;脑内环形病变可出现壁结节 ,它对脑肿瘤诊断有较特征性意义 ,多发壁结节对环形星形细胞来源肿瘤的诊断有特殊价值 ;环壁脐样凹陷在星形细胞来源肿瘤、脑转移瘤、脑脓肿三者中出现率相近 ,无明显定性价值。

Objective To evaluate CT scan in the diagnosis of supratentorial intracerebral solitary circular lesions.Materials and Methods CT findings in 58 cases with surgically and pathologically proved supratentorial intracerebral solitary circular lesions were retrospectively reviewed. The lesions included astrocytoma (n=19), ependymoma (n=4), cerebral metastases (n=18), cavernoma (n=1) and brain abscess (n=16). Results As each disease had its own pathologic process, CT signs were different from one to the other. The location, shape and enhanced degree carried a certain value for the making of the diagnosis. Parietal nodule was occasionally seen in the circular lesions, which had special significance for the diagnosis of brain tumors. Multiple parietal nodules in a lesion was almost a pathognomonic sign for the diagnosis of astrocytoma. The incidence of umbilicated indentation in astrocytoma, cerebral metastases and brain abscess was nearly the same, showing no value in qualitative diagnosis.Conclusion CT scan has much value in the diagnosis of supratentorial intracerebral solitary circular lesions.