脑脱髓鞘假瘤的临床和影像学特点(附1例报告)

Clinical and image characteristics of demyelinating pseudotumor( report of 1 case)

目的探讨脑脱髓鞘假瘤的临床和影像学特点。方法回顾性分析1例脑脱髓鞘假瘤患者的临床资料。结果本例患者以左侧肢体活动不灵敏、感觉障碍为主,无明显头痛、头晕、恶心等高颅压症状。头颅MRI平扫:右侧额颞顶部颅内占位性病变。头颅MRI强化:右侧额叶可见团片状不均匀异常强化信号影,边界较清楚,周围见片状低信号水肿带。手术切除后病理检验提示脑脱髓鞘假瘤。结论脑脱髓鞘假瘤主要临床表现以神经系统功能障碍为主;影像学上多表现为脑内单发肿块,增强扫描病变多呈弥漫性强化或环形强化,酷似脑内原发肿瘤或转移瘤,常被误诊而行手术切除。

Objective To investigate the clinical and image characteristics of demyelinating pseudotumor （DPT）.Methods The clinical data of one case of DPT was retrospectively analyzed.Results The patient involved manifested mainly disabled left-side limbs movement and sensation impair,without obvious symptoms of high intocranial pressure e.g.headache,dizziness and nausea,plain MRI scan displayed introcranial space occupying lesion in right frontotemporal cupula.Image-enhanced MRI showed uneven mass in right frontal lobe,with comparative clear margin and low signal of peripheral edema zone.Post-operative pathology indicated DPT.Conclusions DPT is characteristic of disorder of nervous system function.Imaging usually demonstrates isolated tumor.Enhanced scan frequently manifests diffused or annular modalities,resembling primary or metastatic lesions,and is often misdiagnozed and mistakenly operated.