脑实质内室管膜瘤的MRI表现与病理结果比较分析

Comparison of MRI Diagnosis and Pathology of Brain Parenchyma Ependymoma

目的比较脑实质内室管膜瘤的MRI表现与病理结果。方法对经手术病理证实的30例脑实质内室管膜瘤进行回顾性分析,均行颅脑MRI平扫及增强扫描检查。结果肿瘤大小:长径2.0~13.0 cm,平均(5.16±2.03)cm。7例发生于幕上;发生于幕下23例。所有病例伴幕上不同程度脑积水。发病男性18例(60.00%),女性12例(40.00%)。发病年龄≤14岁6例(20.00%);>14岁24例(80.00%)。Ⅰ~Ⅱ级21例,占比70.00%;Ⅲ级9例,占30.00%。幕上Ⅰ~Ⅱ级5例,Ⅲ级2例,幕下Ⅰ~Ⅱ级16例,Ⅲ级7例。手术全切21例(70.00%);进行手术大部分切除9例(30.00%)。MRI表现:T1加权像上,长T1∶等T1∶短T1∶混杂信号=16∶4∶2∶8;T2加权像上,长T2∶等T2∶混杂信号=18∶2∶10;肿瘤内部信号均匀者6例,不均匀者24例,其中有16例出现肿瘤内囊变;肿瘤边界清晰者7例,边界欠清晰者23例;瘤周无明显水肿者22例,7例轻度水肿,1例重度水肿;肿瘤无强化者4例,强化者26例,其中不均匀强化者25例。MRI诊断准确率(83.3%)和病理确诊比较,差异无统计学意义(P>0.05)。结论 MRI能较清楚显示室管膜瘤病灶,对诊断及鉴别脑实质内室管膜瘤具有重要价值。

Objective To observe and compare the MRI diagnosis and pathology of brain parenchyma ependymoma . Methods 30 cases of brain parenchyma ependymoma which pathologically confirmed were reviewed retrospectively , underwent plain and enhanced MRI brain scan .Results The tumor size：long diameter range 2.0 cm^13.0 cm,the average （5.16 ± 2.03） cm.7 cases were occurred on the screen ,and 23 cases were occurred in the screen .All patients are varying degrees of hy-drocephalus on screen.The incidence of males 18 cases （60.00%） and 12 females （40.00%）.Age ≤14 years and 6 cases （20.00%）;〉14 years 24 cases （80.00%）.GradeⅠ~Ⅱ were 21 cases,accounting for 70.00%;grade Ⅲ were 9 cases,ac-counting for 30.00%.Supratentorial gradeⅠ~Ⅱwere 5 cases,gradeⅢwere 2 cases,infratentorial level Ⅰ~Ⅱwere 16 cases, grade Ⅲwere 7 cases.Totally resected were 21 cases （70.00%）;surgery subtotal were 9 cases （30.00%）.MRI findings：1,on T1-weighted images ,long T1：etc T1：Short T1：mixed signal=16：4：2：8;T2-weighted images ,long T2：et T2：mixed signal =18：2：10;2,the internal signal tumor in 6 patients uniformly uneven in 24 cases,including 16 cases of cystic tumor;3,7 cases the tumor with clear boundary ,boundary less clear in 23 cases;4,no peritumoral edema 22 cases,seven cases of edema ,one case of severe edema;5,no tumor enhancement in 4 cases,enhancement in 26 cases,25 cases in which heterogeneous enhancement . MRI diagnostic accuracy （83.3%） and pathological diagnosis ,the difference was not statistically significant （P〉0.05）.Con-clusion MRI can more clearly show ependymoma tumor ,and is of important significance in the diagnosis and differential diagno-sis of brain parenchyma ependymoma .