颅内血管外皮细胞瘤的CT、MRI、DSA诊断

CT, MRI and DSA Diagnosis of Intracranial Hemangiopericytoma

目的 探讨颅内血管外皮细胞瘤的影像学表现 ,提高对血管外皮细胞瘤的影像学认识和诊断水平。资料与方法 搜集 11例经手术及病理证实的血管外皮细胞瘤患者 ,男 7例 ,女 4例 ,年龄 2 5～ 6 9岁。 11例均行CT扫描 ,7例行MRI检查 ,7例行DSA检查。结果 CT平扫 ,6例为高密度 ,5例为不均匀混杂密度 ;增强后 ,病变的实性部分表现为明显均匀强化或不规则周边强化。 7例MRI检查 ,在T1WI上 ,3例为等信号 ,4例为略高混杂信号 ;T2 WI上 ,4例为混杂信号 ,3例为等信号 ;增强后 ,肿瘤明显强化。DSA表现为排列粗细不均、弯曲变形的动脉 ,并在静脉期可见明显“肿瘤染色”。结论 在CT、MRI、DSA上 ,颅内血管外皮细胞瘤不具备特征性影像表现 ,联合影像学检查有助于提高对血管外皮细胞瘤的诊断。

Objective To investigate the imaging features of intracranial hemangiopericytoma, to improve its diagnostic accuracy.Materials and Methods Eleven patients (7 males and 4 females, aged 25～69) with pathologically proved intracranial hemangiopericytoma were collected. CT scanning was performed in all 11 cases, while additional MRI in 7 and DSA in 7 cases. Results On plain CT scans, the lesions were of hyperdensity in 6 and inhomogeneous density in 5 cases. After enhancement, the solid part of the lesion showed marked homogeneous enhancement or irregular peripheral enhancement. On T 1WI, iso signal was seen in 3 cases, and slightly higher signal in 4 cases. On T 2WI, the lesions displayed inhomogeneous signal in 4 and iso signal in 3 cases, and showed marked enhancement after injection of Gd DTPA. On DSA, the lesions were characterized by irregular, curved arteries and obvious 'tumor staining'.Conclusion Intracranial hemangiopericytoma has no pathognomonic signs on CT, MRI or DSA, but a combination of the above imaging findings is helpful in the diagnosis of the disease.