中枢神经细胞瘤CT、MRI诊断分析

The imaging diagnosis of the central neurocytoma on CT and MRI

目的分析总结中枢神经细胞瘤(central neurocytoma,CNC)的影像学特征,以提高诊断率。方法回顾性分析安徽省立医院南区自2010年7月至2018年2月手术病理证实的35例CNC患者的影像学资料,男21例,女14例,年龄24～66岁,平均年龄33岁。结果 35例均位于侧脑室内,其中25例位于侧脑室前部或近孟氏孔区。CT平扫多为等密度或稍高密度,常见钙化及囊变;MRI平扫T1WI表现为等或稍低信号,T2WI表现为稍高信号。30例可见囊变(85%),25例瘤体内或周边见强化血管影(71%);MRI增强扫描28例轻中度强化(80%),7例病例明显强化(20%)。15例行DWI(b值=1000s/mm^2),均为高信号。10例行MRS,表现为NNA下降、CHO升高、CHO/NAA比值升高。结论 CNC影像学表现具有一定的特征性(钙化、囊变、血管影、瘤周轻或无水肿、轻中度强化),CT和MRI有助于中枢神经细胞瘤的诊断和鉴别诊断。

Objective To evaluate and summaize the central neurocytoma（CNC）imaging characteristics in order to improve the diagnostic rate.Methods 35 cases with CNC which were confirmed by pathology,and were retrospectively analyzed on CT and MRI from Jul 2010 to Feb2018 in anhui province Hospital for the southern district.The patients included 21 males and 14 females,aged 24-66 with the average of 33 years.Results 35 cases of CNC were located at Lateral ventricle of the brain,Among of them,25 cases were located in the front of the lateral ventricle or near the monro area.The cases presented as iso-density or slightly high density on CT,calcification and cystic signs were very common.The cases demonstrated hyper-intensity and iso-intensity signal on T1 WI and hyper-intensity signal on T2 WI.cystic changes appeared in 30 cases（85%）,Enhanced vessels appeared in 25 cases（71%）peripheral area within the lesions.28 cases（80%）revealed mild to moderate enhancement,7 cases showed obviously enhancement.15 cases with DWI（b=1000 s/mm-2）Showed high signal intensity,10 cases with MRS showed prominent choline（cho）and low N-acetyl aspartate（NAA）compared to the normal,and CHO/NAA increased.Conclusion The appearance of CNC on CT and MRI in the lateral ventricle has some characteristics（calcification,cystic change,enhanced vessels,light or no edema,mild to moderate enhancement）.Which may be helpful to the diagnosis and differentiation from other tumors.