探讨CT联合MR对中枢神经系统胆脂瘤诊断价值

To Investigate the Value of CT Combining MRI in Diagnose of Cholesteatoma of the Central Nervous System

目的:探讨中枢神经系统胆脂瘤CT、MR表现,提高CT联合MR对中枢神经系统胆脂瘤诊断的正确率。方法:回顾性分析我院2015年1月-2019年3月收治中枢神经系统胆脂瘤共38例,男性25例,女性13例,所有患者术前均行CT及MR检查。结果:本组38例中枢神经系统胆脂瘤中发生于桥脑小脑角区22例,鞍区6例,颅中窝4例,脑室系统3例,脑实质2例,颅骨1例。病灶形态常不规则,"见缝就钻",呈哑铃型、塑形生长。CT平扫呈均匀低密度18例,呈不均匀低密度、内条片状或不规则形稍高密度15例,呈稍高密度5例;增强扫描强化不明显15例,边缘条片状强化23例;出现边缘钙化者8例。MR平扫T1WI低信号为主,内见多发斑片状高信号;T2WI及FLAIR呈不均匀高信号,DWI呈明显高信号;增强周边见包膜样强化。结论:中枢神经系统胆脂瘤形态常不规则,"见缝就钻",呈哑铃型、塑形生长;DWI呈明显高信号,周边包膜样强化为其特征性表现,联合CT及MRI可提高诊断正确率。

Objective:By categorizing the characteristics of cholesteatoma of the central nervous system, we aimed to improving the acuracy of diagnosis of cholesteatoma.Methods:The characteristics on radiology of 38 case of cholesteatoma of the central nervous system was reviewed retrospectively.Results:Of the 38 case,22 cases in the cerebellopontine angle, 6 case in the saddle region, 4 case in the middle cranial fossa, 3 case in the ventricular system, 2 case in the parietal lobe and 1 case in the harnpan. The shape of cholesteatoma is often irregular. CT plain show homogeneous hypodensity in 18 cases, inhomogeneous hypodensity in 15 cases, slightly high density in 5 cases. The enhancement is not obvious in 15 cases and edge strip enhancement in 23 cases. There were 8 cases of marginal calcification. MR plain is dominated by low signal in T1 WI, and multiple high signal observed in it. T2 WI and FLAIR showed nhomogeneous hyperintensity, and DWI showed obvious hyperintensity. Capsule enhancement is seen around the enhancement.Conclusion:The cholesteatoma of central nervous system is often irregular in shape, obvious high signal on DWI, and peripheral capsule enhancement. The combination of CT and MRI could improve the diagnostic accuracy.