脉络丛肿瘤的影像学征象与病理对照分析

Choroid plexus tumor:a comparative study between CT and MRI and correlated with pathology

目的：探讨脉络丛肿瘤（CPTs）的CT和MRI表现特征,提高影像诊断的准确性。方法：回顾性分析28例经病理证实的CPTs患者的影像学资料,其中脉络丛乳头状瘤（CPP）22例,非典型性脉络丛乳头状瘤（ACPP）2例,脉络丛癌（CPC）4例。全部病例均行CT平扫、MRI平扫及增强扫描。结果：28例CPTs患者中男16例,女12例,年龄5个月~66岁,中位年龄30岁。发病部位包括侧脑室（12例）、第四脑室（8例）、桥脑小脑角区（6例）、三脑室（1例）和小脑蚓部（1例）。CPPs CT平扫多表现为较均匀等密度或稍高密度,其中6例伴有钙化;肿瘤实性部分在T1WI上呈等或稍低信号,T2WI上呈等或稍高信号;MRI增强扫描示肿瘤实性部分及囊壁呈明显强化。CPPs内可见肿瘤血管,出血和囊变少见;APCCs更易发生囊变,可侵犯周围脑实质,易出现瘤周水肿;CPCs可见瘤内出血、囊变、脑实质浸润、沿脑脊液播散等改变。结论：脉络丛肿瘤的CT和MRI表现具有一定的特征性,MRI能清晰显示肿瘤的形态学改变,为手术方案的制定及预后判断提供可靠的依据。

Objective：To study MRI and CT features of choroid plexus tumors,thus to improve the accuracy of imaging diagnosis.Methods：Imaging data of 28 patients with pathologically proved choroid plexus tumors（CPT）were analyzed retrospectively,including 22 cases with choroid plexus papillomas（CPP）,2cases with atypical choroid plexus papillomas（ACPP）,and 4cases with choroid plexus carcinomas（CPC）.All the patients underwent plain CT,non-enhanced and enhanced MRI.Results：Among 28 cases of choroid plexus tumors,there were 16 males and 12 females,aged from 5months to66 years with median age of 30 years.Twelve tumors were located in the lateral ventricle,8were in the fourth ventricle,6in the cerebellopontine angle,one in the third ventricle and one in the cerebellar vermis.The CPPs appeared as lobulated masses with homogeneous intermediate or slightly high density on plain CT images,calcification could be seen in 6cases.The CPPs showed iso-or slightly hypointense on T1 WI,iso-or slightly hyperintense on T2WI;solid areas,cystic wall and septations in the tumors were significantly enhanced.Tumor vessels were visible in some CPPs,but hemorrhage and cystic changes were uncommon.Cystic changes,infiltration of brain parenchyma and peritumoral edema were common findings in ACPPs.cystic changes,hemorrhage,infiltration of brain parenchyma,and cerebrospinal fluid dissemination could be seen in CPCs.Conclusion：Choroid plexus tumor has certain characteristic features on CT and MRI,MRI can clearly show the morphological details of the tumor,thus can be more helpful for surgical planning and prognostic evaluation.