第四脑室内表皮样囊肿的MRI诊断与临床分析

The MRI Diagnosis and Clinical Analysis of Fourth Ventricle Epidermal Cyst

目的探讨第四脑室内表皮样囊肿的临床表现特点及MRI诊断与鉴别诊断价值。方法回顾性分析经手术病理证实的9例(男5例,女4例)第四脑室内表皮样囊肿患者的临床及影像资料,重点分析MRI特点及手术病理特征。结果 9例患者中,7例行磁共振平扫与增强检查,1例患者行磁共振平扫检查,1例患者直接增强扫描。T_1WI上6例呈低信号,3例呈混杂低信号;T_2WI上5例高信号,3例呈高低混杂信号;FLAIR上2例混杂稍高信号,2例低信号,3例等低信号,1例不均匀低信号;DWI上7例呈明显高信号,1例不均匀稍高信号,1例轻度高信号。静脉注入Gd-DTPA后,7例无强化,1例边缘见线状高信号。结论第四脑室内表皮样囊肿以先天性多见。MRI影像表现具有特征性,对病变诊断及鉴别诊断有重要价值。

Objective To investigate the clinical features and the value of MRI in diagnosing the fourth ventricular epidermal cyst. Methods We analyzed the clinical and imaging data of nine cases（ male 5 cases,female 4 cases） epidermal cyst in the fourth ventriclar retrospectively,which were confirmed by surgery and pathology. We mainly analyzed MRI features and surgical pathologic features. Results Among the 9 patients,7 patients underwent MR plain scan and enhanced examination,1 patient underwent MR plain scan,1 patient directly underwent MR enhanced scan. On T_1WI,6 cases showed low signal intensity,3 cases showed mixed low signal intensity. On T_2WI,5 cases with high signal intensity,3 cases showed mixed high-low signalintensity. On FLAIR,2 cases had mixed slight hyperintensity,2 cases had hypointensity,3 cases iso-to low signal intensity,1 case inhomogeneous low signal. On DWI,7 cases showed obvious hyperintensity,1 case inhomogeneous slight hyperintensity and 1 case was slightly hyperintense. After the injection of Gd-DTPA,7 patients had no enhancement,1 patient showed linear enhancement. Conclusion Fourth ventricle epidermal cyst is congenital,and the MRI features are characteristic,which is of great value to diagnosis the disease.