小脑血管母细胞瘤MR表现及病理分析

MR Diagnosis and Pathological Analysis of Cerebellar Hemangioblastoma

目的探讨小脑血管母细胞瘤的MR影像表现与病理特点,以提高术前诊断准确率。方法回顾性分析经手术病理证实的22例小脑血管母细胞瘤,全部患者均行MR平扫及增强扫描。结果单发21例,多发1例,所有病灶均位于小脑内。21例单发病例中,MR表现大囊小结节型17例,实质型2例,单纯囊型2例。肿瘤的囊液部分显示为长T1长T2信号,T2-FLAIR为稍低、等或稍高信号;实性部分或瘤结节呈稍长T1稍长T2信号,增强后明显强化。SWI序列可见到瘤内或瘤周的异常扭曲血管影。1例多发病例表现为1个大囊小结节型及2个小结节状实质型病灶。病理组织学检查肿瘤主要由两种成分构成:不同成熟阶段的毛细血管和毛细血管网之间丰富的间质细胞。结论小脑血管母细胞瘤具有典型的MR表现,且与其病理基础密切相关。MR是诊断小脑血管母细胞瘤的有效检查方法。

Objective To analyze the MR feature and pathological findings of the cerebellar hemangioblastomas so as to raise the diagnostic accuracy. Methods MR imaging and pathological features of the cerebellar hemangioblastomas in 22 cases were analyzed retrospectively. All of the patients underwent routine enhanced MR scan. Results There were 21 cases with solitary tumor and 1 case multiple tumors. A total of 22 hemangioblastomas were located intracerebellar.Among 21 solitary cases, 17 cases were large cystic with small nodule type, 2 cases were solid mass type, and 2 cases were purely cystic type. The cystic liquid exhibited the long T1 and T2 signal and nearly isointense on T2-FLAIR. The solid part or nodule showed slightly low signal on T1 WI, slightly high signal intensity on T2 WI and could be significantly enhanced. It could be appeared distortion abnormal blood vessel within and around the tumor on SWI. 1 case multiple tumors included 1 large cystic with small nodule and 2 small solid nodules type. Histopathologically, this tumor was characterized by two main components： capillary and stromal cells. Conclusion The MR findings of the cerebellar hemangioblastoma has certain features, which are closely related to its pathology. MR is the effective inspection method for cerebellar hemangioblastoma.