中枢神经系统神经母细胞瘤的CT、MRI诊断(附6例报告)

CT and MRI diagnosis of central nervous system neuroblastomas(a report of 6 cases)

目的分析中枢神经系统神经母细胞瘤的影像学特点,探讨CT及MRI对该病的诊断价值。材料与方法对6例经手术病理证实的中枢神经系统神经母细胞的影像资料进行回顾性分析。结果男5例,女1例,年龄3~24岁,平均13.8岁。幕上3例,分别位于颞极区1例,颞枕叶及顶叶各1例;幕下四脑室内和桥脑各1例,另1例跨小脑天幕。肿块呈囊实性2例,实性为主4例。MRI表现肿瘤实性部分呈等或稍长T1、T2信号,FLAIR序列呈等、稍高信号;囊性部分呈长T1、长T2信号,FLAIR序列呈低信号;增强扫描后,2例强化不明显,4例肿瘤实性部分呈明显强化,肿块边界较清楚,瘤周水肿较轻。CT表现肿瘤实性部分呈等、稍高密度,其内可见钙化,囊性部分呈低密度。结论中枢神经系统神经母细胞瘤影像表现有一定的特点,根据肿瘤部位、边界、信号(或密度)、水肿、增强等特点有助于该病的诊断和鉴别诊断。

Objective： To analyze the CT and MR characteristics of central nervous system （CNS） neuroblastomas and explore the diagnostic value of CT and MRI. Materials and Methods： CT and MR imaging features of 6 patients with CNS neuroblastomas confirmed by pathology were analyzed retrospectively. Results： Six patients were enrolled, 5 patients were male and I female, their age ranged from 3-- 24 years old and the average age 13.8 years old. Among them, 3 cases were above tentorium, temporal lobe （1）, occipital lobe （I）, parietal lobe （1）. And 2 cases were below tentorium, fourth ventricle （1） and the pons （1）, the rest 1 case was astride left cerebellum tentorium. Two cases were cystic-solid mass, 4 cases were mainly solid mass. The solid part of tumor presented iso-or hypointensc on T1WI, iso-or hyperintense on T2WI, and iso-or slightly hyperintense on T2 FLAIR, after contrast, 2 cases with no obvious enhancement, and 4 cases with significant enhancement. The cystic part of tumor displayed hypointense on TI WI, hyperintense on T2WI, and hypointence on FLATR sequence. The tumor were well defined and peritumoral edema was not obvious. On CT, the tumor solid compontent showed iso- or hyper- density, calcification may be seen, and the cystic compontent showed hypo-density. Conclusions： The imaging of CNS neuroblastoma has certain characteristics on CT and MRI. It may help to the diagnosis and differential diagnosis of the disease based on tumor location, boundary, signal （or density）, edema, enhancement, etc.