颅内皮样囊肿破裂的CT、MRI诊断

Diagnose of MRI and CT for Rupture of Intracranial Dermoid Cyst

目的探讨颅内皮样囊肿破裂的CT、MRI表现,以提高对本病的进一步认识。方法回顾性分析经手术病理证实的12例颅内皮样囊肿并破裂病例,均行MRI SE序列T1WI、T2Wl、T2Wl Flair及DWI序列扫描,其中3例行T1WI压脂增强扫描,4例行脑CT平扫。结果 12例中,皮样囊肿位于桥小脑角区5例,桥前池2例,颞极1例,鞍旁2例,鞍上2例,病变呈不规则形或类圆形,CT表现为低密度,T1WI为高信号或混杂高信号,T2WI为不均匀高信号,T2Wl Flair为不均匀高信号,DWI扩散受限,压脂增强扫描不强化。皮样囊肿破裂CT、MRI表现在脑沟、脑池或脑室内有低密度脂肪滴影,CT值-70-140HU,或短T1的脂肪滴影,T2WI信号略有衰减,压脂T1Wl增强呈极低信号。2例侧脑室内见脂滴,3例位于大脑纵裂池,3例位于侧裂池,2例位于侧裂池及大脑纵裂池,2例脂滴位于环池。结论颅内皮样囊肿破裂具有较特征性CT、MRI表现,能较好地显示病变的生物学特征,有助于鉴别诊断及指导制定治疗方案。

Objective To study the value of MRI and CT in the diagnosis to rupture of intracranial dermoid cyst, and to improve the understanding of its imaging findings. Methods In the 12 cases of rupture of intracranial dermoid cyst proved by pathology and surgery were retrospectively analyzed, were performed MRI SE T1 WI, T2 Wl, T2 Wl flair and DWI sequence scan, of which three cases T1 WI pressure fat enhancement scan, 4 cases brain CT scan. Results Among the 12 cases with intracranial dermoid cyst, located in the CPA 5 cases, 2 cases were identified in the pons before pool, temporal pole is 1 case, beside to the saddle in 2 cases and 2 cases on the saddle, the lesion showed irregular or like-round masses, CT characterized by low density, T1 WI for high signal or mixed signal, T2 WI for heterogeneous high signal, T2 Wl flair for heterogeneous high signal, DWI restricted diffusion, the press fat enhancement scan is not improved. CT and MRI revealed low density fat drop shadow in the sulci, pool or ventricle for rupture of intracranial dermoid cyst, CT value in-70~140HU, or short T1 fat drop shadow, T2 WI signal attenuation slightly, the press fat T1 Wl enhancement has very low signal, 2 cases lipid droplets in the lateral ventricular, 3 cases located in the longitudinal crack pool, 3 cases located in lateral fissure pools, 2 cases located in lateral fissure pools and longitudinal crack pool, the other 2 cases of lipid droplets in ring pool. Conclusion The rupture of intracranial dermoid cyst show characteristic manifestations on CT and MRI, can show structures and extent of the lesion very well, which is helpful in differential diagnosis and guide treatment plan.