12例颅内血管外皮细胞瘤的影像及病理表现

Imaging and pathology features of intracranial hemangiopericytoma in 12 patients

目的:提高对颅内血管外皮细胞瘤(HPC)影像认识及诊断水平。方法:回顾性分析12例经手术病理证实的颅内HPC的CT、MRI及病理资料。结果:12例颅内HPC均为单发病变。11例位于颅内脑实质外,7例位于天幕上(2例跨大脑镰成长,3例位于大脑镰旁,2例位于外侧裂区),2例跨小脑天幕成长,1例位于鞍内并伸向鞍上,1例位于后颅窝小脑外。1例HPC位于中央旁小叶。12例的边缘均呈深分叶状改变。8例病变周边及内部有多发囊变,9例内部可见流空血管影。11例与硬膜囊相邻,9例以窄基底与硬脑膜相邻,2例以宽基底与硬脑膜相邻。肿瘤质地柔软,为红色或灰红色,血供丰富,部分肿瘤有包膜;肿瘤内多有薄壁血管,VIM染色阳性,VEM阴性。结论:对于与硬脑膜相邻的颅内脑外肿瘤,当肿瘤以窄基底与硬脑膜相邻,边缘呈深分叶状,肿瘤内部有多条流空血管,有囊变等征象时,要考虑到颅内HPC的可能。

Objective： To improve the knowledge of imaging features and diagnostic accuracy of intracranial heman- giopericytoma （HPC）. Methods：CT,MRI and pathology materials of twelve patients with HPC proved by surgery and pa- thology were retrospectively analyzed. Results：All of thel2 HPC had single lesion. Eleven patients had the lesion located in tracranial extra cerebral parenchyma, seven located at supra-tentorium （across falx cerebri, n= 2 ; para-falx cerebri, n= 3 ; within lateral fissure,n= 2） and four located at infratentorium （across cerebellum and tentorium, n= 2;within sellar tunica and extended to super-sellar area, n= 1; within posterior cranial fossa yet extra-cerebellum, n= 1）. All of the 12 cases showed deep-lobulated contour. Cystic degeneration within the tumor or located peripherally could be seen in 8 patients and flow void vessels were seen in 9 patients. 9 patients had the tumor attached to the cerebral dura with narrow base and 2 with wide base. The lesions had tenacious texture, red or grayish-pink in color with prominent vascular supply. Part of the tumors were encapsulated. Most of the tumors had thin wall blood vessels. Immunohistochemical examination revealed positive ex- pression of VIM and negative expression of VEM. Conclusion：As for intracranial tumors with narrow base attachment to cerebral dura,if the tumor had deep-lobulation, flow void vessels, and cystic degeneration, the possibility of intracranial hemangiopericytoma should be take in consideration.