颅骨海绵状血管瘤的CT与MRI表现

CT and MRI diagnosis of calvarial cavernous hemangioma

目的探讨颅骨海绵状血管瘤(CCH)的临床及CT、MRI表现。方法对经手术病理证实的11例CCH患者的临床及CT、MRI资料进行回顾性分析,并结合术后病理探讨其影像学成像基础,总结其CT及MRI表现。结果 CT检查中,1例CCH肿瘤向颅内侧生长为主,内板受累破坏;4例向颅骨外侧生长为主,外板受累破坏;5例同时向颅内外侧生长,内外板均受累。6例病灶区内见自中心向周边呈放射状骨嵴影,4例病灶区颅骨不规则破坏,未见明显放射状骨嵴影。MRI检查中,7例T1WI呈等低信号,1例T1WI呈高低混杂信号,T2WI均呈不均匀高信号,增强后均不均匀明显强化。结论肿瘤内见放射状高密度骨嵴影,在MRI上信号混杂且增强后不均匀强化等特点是CT及MRI诊断CCH的关键。CT和MRI联合应用能对其诊断和治疗提供更全面的信息。

Objective To analyze the CT and MRI features of calvarial cavernous hemangioma（ CCH）. Methods The CT and MR images of 11 patients with pathologically proved CCH were retrospectively analyzed,imaging features were compared with pathological results to summarize the MRI and CT findings. Results In CT examination,the CCH lesion influced the inner layer of the skull in 1 case,without the outer layer. In 4 cases,the lesions influced the outer layer of the skulls without the inner layer. The inner and outer layer of the skulls were influced in 5 cases. Bone spicules extending from center to periphery in the lesions were seen in 6 cases. Four cases of irregular destruction of the skull,there was no obvious bone spicules. The MR signal of CCH was variable,7 cases of low signals and 1 case of mixed signals on T1-weighted sequences,high signals on T2-weighted sequences and heterogeneous enhancing effects on gadolinium-enhanced T1-weighted sequences in all 8 cases.Conclusion Bone spicules in the lesions,the mixed signals in MR and heterogeneous enhancement features and bone spicules in the lesions is the key to diagnosis of CCH. The combined application of CT and MRI can provide more comprehensive information for its diagnosis and treatment.