颅内血管外皮细胞瘤的磁共振误诊分析

MR misdiagnosis of intracranial hemangiopericytoma

目的通过回顾性分析17例颅内血管外皮细胞瘤的磁共振(MR)表现,提高术前诊断,降低误诊率。方法回顾性分析17例经手术病理证实的颅内血管外皮细胞瘤。其中17例行MR平扫及增强扫描,其中6例行DWI扫描并测量ADC值。结果 17例血管外皮瘤中16例为单发病灶,1例为脑内多发病灶,病灶边界清晰,14例病灶呈分叶或浅分叶状。MR平扫T1WI:8例呈混杂信号,3例呈稍低信号,3例呈等信号,2例呈稍高信号,1例呈低信号;T2WI:10例呈混杂信号,4例呈等信号,2例呈稍高信号,1例呈高信号;FLAIR:病灶呈等或稍高信号。行DWI扫描6例病灶中5例实质部分呈低或稍低信号。增强扫描16例呈不均质明显强化,8例可见明显坏死囊变,7例瘤体内可见出血信号,15例肿瘤体内或边缘可见散在小囊状或多发迂曲的流空血管影。14例肿瘤周围可见不同程度水肿信号。结论颅内血管外皮细胞瘤MRI平扫及增强扫描表现有一定的特征性,结合DWI检查有助于提高术前诊断率。

Objective To analyze the MR features of 17 cases of intracranial hemangiopericytoma,to improve the preoperative diagnosis and to reduce the misdiagnosis rate.Methods Retrospective analysis was conducted of 17 cases of intracranial hemangioma confirmed by surgery and pathology.Among them,17 cases underwent pre and post enhanced scan,of which 6 cases underwent DWI scan and ADC values measured.Results There were 16 cases of solitary lesions,1 case of brain multiple lesions,lesions all with clear border;14 cases showed lobulated.As for MR scan T1WI,8 cases showed mixed signal,3 cases showed slightly low signal,3 cases showed equisignal,2 cases showed slightly high signal,and 1 case showed low signal;As for T2WI,10 cases showed mixed signal,4 cases showed equisignal,2 cases showed slightly high signal,and 1 case showed high signal;FLAIR lesions showed slightly high signal.DWI image of 5 cases showed low or slightly low signal.Enhanced scanning in 16 cases showed heterogeneous enhancement,8 cases showed cystic necrosis,7 cases tumor hemorrhage signal,and 15 cases of tumor or edge scattered with sacculiform vessels or multiple tortuous vessels.14 cases of tumors were seen with different degrees of edema signal.Conclusions The MRI scan and enhanced scan of intracranial hemangioma have certain characteristics,which is helpful to improve the preoperative diagnosis rate combined with DWI examination.