颅内原发黑色素瘤的MRI与病理特征分析

Explore the MRI Manifestations and Pathological Features of Intracranial Primary Melanoma

目的探讨颅内原发黑色素瘤的MRI表现与病理特征。方法搜集本院2011年5月至2016年9月经组织病理学诊断的颅内原发黑色素瘤患者8例,回顾性分析其MRI表现与病理特征。结果其中7例病灶出现囊变坏死,病灶周围有大片水肿;T1WI4例呈高信号,3例呈混杂信号,1例呈环形高信号;T2WI4例呈稍高信号,2例呈混杂信号,2例呈明显低信号;DWI3例可见扩散受限稍高信号。2例呈低信号,3例呈等信号。经静脉注射Gd—DTPA后,8例均有不同程度强化,2例可见邻近脑膜线状强化。免疫表型:所有病例HBM-45、Melan.A、S100均表达阳性,Ki-6720%~90%阳性表达。结论典型黑色素性黑色素瘤MRI表现具有特征性,病灶周边及病灶内的短T2信号、囊变坏死、邻近脑膜强化等征象有助于非典型黑色素瘤的诊断。

ObjectiveExplore the MRI manifestations and pathological features of intracranial primary melanoma.Methods Retrospective analysis of the MRI manifestations and pathological features of 8 cases of primary intracranial melanoma,which are diagnosed by conventional dyeing and immunohistochemical between 2011 and 2016.ResultsMost of the lesions appear as cystic necrosis,large surrounding edema;T1WI:4 cases show high signal,3 cases of mixed signals,1case of annular high signal,T2WI:4 cases were slightly higher signal,2 cases of mixed signals,2 cases had significantly low signal;DWI:3 cases of high signal,2 cases of low signal.After intravenous injection of Gd-DTPA,all cases show varying degrees of enhancement,2 cases show meningeal enhancement.Conclusion 1,the typical melanoma MRI performance is characterized.2,short T2signal surrounding or within lesions,necrosis and cystic,the enhancement of meninges near lesions may help the diagnosis of melanoma.