颅内血管外皮细胞瘤19例MRI分析

MRI Manifestations of Intracranial Hemangiopericytoma: An Analysis of 19 Cases

目的探讨颅内血管外皮细胞瘤(HPC)的MRI特征及诊断价值。方法回顾性分析19例经手术病理证实的颅内HPC患者的影像资料,对其MRI检查资料进行分析、总结。结果 19例HPC均为单发病灶。平扫均具有颅内脑外肿瘤的征象,边界清晰,周围脑组织受压;平扫8例表现为信号不均,T1WI、T2WI等信号为主,16例瘤体内可见到流空血管;14例内部可见囊变坏死区;13例出现瘤周水肿,12例与邻近脑膜窄基底相连。增强后15例表现为明显不均匀强化,4例均匀明显强化,7例邻近硬脑膜出现"鼠尾"状强化。结论颅内HPC具有一定的MRI特征,分析其特点有助于提高术前诊断符合率,明显的恶性征象更有助于和Ⅰ级脑膜瘤鉴别。

Objective To explore the MRI features of intracranial hemangiopericytoma（ HPC）,and to discuss the diagnostic value of MRI. Methods A total of 19 cases with pathologically-proved HPC were enrolled in this study. The MRI materials were retrospectively analyzed. Results The lesion was single in all cases. Plain MRI scanning showed that all the lesions were intracranial and were located outside the brain. The lesion had a clear margin with the adjacent brain tissue being compressed. The lesions were manifested as inhomogeneous signals,iso-intensity on T1 WI and T2 WI,and vascular flow void sign was demonstrated in 16 cases. Necrotic cystic necrosis was seen in 14 cases,peritumoral edema was found in 13 cases,and adhesion of the lesion to adjacent narrow base of dura was detected in 12 cases. On contrast-enhanced MRI,obvious inhomogeneous enhancement was displayed in 15 cases and homogeneous enhancement in 4 cases.＂Rat tail＂enhancement nearby the adjacent dura was seen in 7 cases. Conclusion Intracranial hemangiopericytomas carry certain MRI characteristics,which are helpful in making preoperative diagnosis. Obvious malignant signs are also very useful in differentiating HPC with maningioma of grade Ⅰ.