中枢神经细胞瘤影像学与病理特征分析

Analysis of radiologic and pathological features of the central neurocytoma

目的探讨中枢神经细胞瘤的临床、影像学及病理特点,旨在提高对该肿瘤的诊断水平。方法回顾性分析12例经手术病理证实的中枢神经细胞瘤的临床症状、影像学及病理学的表现。结果 11例肿瘤均位于侧脑室透明隔,邻近Monro孔,1例位于右侧小脑半球,肿瘤形态均不规则,界限清楚。5例肿瘤行CT平扫,4例见不同程度钙化征象,呈混杂密度,实性部分呈稍高密度。MRI平扫,多数肿瘤T1WI呈等、低信号,T2WI呈不均匀等、稍高信号。8例肿瘤呈囊实性,囊性部分主要位于病灶边缘部。T2WI 3例病灶呈"海绵征",4例病灶呈"冒泡征"改变,增强扫描囊变区间的索条样分隔中等强化,呈"丝瓜瓤"状改变。增强检查8例肿瘤实质部分呈中等-明显不均匀强化,5例肿瘤内可见粗大的血管影。病理检查见肿瘤由形态一致的小圆细胞组织,其内血管丰富。免疫组化染色:突触素和神经元特异性烯醇化酶呈阳性。结论中枢神经细胞瘤临床表现、MRI及病理学表现有一定的特征性,结合年龄及典型发病部位特点,有助于与其他脑室内肿瘤鉴别。

Objective To investigate the clinical ,radiologic and pathological features of the central neurocytoma （CNC） in order to improve diagnostic level .Methods 12 patients with CNC were confirmed by surgy and pathology and the clini‐cal ,radiologicand pathological features of them were retrospectively reviewed .Results 11 lesions located in the lateral ventricle septum pellucidum ,adjacent to Monro hole ,and one lesion located in the right cerebellum hemisphere ,with ir‐rugular shape and sharp edge .5 patients underwent CT plain scans ,4 cases presented with different degrees of calcifica‐tion ,and their density was inhomogeneity ,with higher density for solid component .The majority presented as hypoin‐tense and equal signal intensity on T1 WI and inhomogeneous hyperintense signal on T2 WI .8 cases showed cyst‐ solidary , with multiple cystic degeneration in the borders of the tumors .On T2 WI ,3 cases showed “spongy” sign and 4 cases showed a “soap bubble” appearance ,of these case ,surrounding the cystic part showed “sponge gourd” patternlike areas on the postcontrast MRI .The postcontrast MR revealed solid part of 8 lesions demonstrated moderate or obvious enhance‐ment ,the thick enhanced vessels were found in 5 patients .All tumours were composed of monotonous neoplastic cells , and riched in blood vessels .The immunohistochemistry revealed syn（＋ ） and NSE（＋ ） .Conclusion CNC has the charac‐teristic appearances on MRI ,pathology and clinical data .When compaired with the onset age and typical part ,it will be helpful to the diagnosis and differentiates the neurocytoma from other tumors residing in lateral ventricle .