松果体区肿瘤的CT和MRI诊断与鉴别诊断研究

CT and MRI diagnosis and differential diagnosis of pineal gland tumors

目的:研究颅内松果体区肿瘤的X射线计算机断层扫描(CT)和磁共振成像(MRI)的临床影像特征以及鉴别诊断。方法:选取经手术或病理证实的40例颅内松果体区肿瘤患者,所有患者均行CT和MRI检查,总结分析其CT和MRI的临床影像学表现及影像特征。结果:40例患者临床影像学表现中,生殖细胞肿瘤(GCTs)15例;畸胎瘤7例;松果体细胞瘤5例;松果体母细胞瘤4例;胶质瘤4例;松果体区乳头状瘤(PTPR)3例;松果体囊肿2例。松果体区肿瘤CT表现为实性或实性和(或)囊性肿块,并有不同程度的增强,畸胎瘤内常含有脂肪、钙化和骨骼;MRI表现为异质性肿块,为长T1和长T2信号,增强后肿瘤均明显强化。该区域因肿瘤组织学来源多样性,可通过脂肪、钙化、囊变及种植播散等特殊图像表现进行鉴别诊断。结论:CT和MRI的多轴位成像联合增强扫描能清晰显示颅内肿瘤的部位、大小、形态及边缘特征,联合应用有助于松果体区肿瘤的定位及定性诊断,鉴别诊断效果MRI优于CT。

Objective:To study the clinically imaging features and differential diagnosis of computed tomography(CT)and magnetic resonance imaging(MRI)for intracranial pineal gland tumor.Methods:40 patients with intracranial pineal gland tumor who were confirmed by surgery or pathology in our hospital or other hospitals were selected.All of them underwent CT and MRI examination.The clinical imaging manifestations and imaging features of them in CT and MRI were summarized and analyzed.Results:In the clinical imaging manifestations of 40 patients,15 cases were germ cell tumors(GCTs),and 7 cases were teratoma,and 5 cases were cell tumor of pineal gland,and 4 cases were pinealoblastoma,and 4 cases were glioma,and 3 cases were pineal papilloma and 2 cases were pineal cyst.Tumors in pineal region showed solid or solid/cystic masses in CT,and there were different degrees of enhancement,and teratoma often contained fat,calcification and bone.MRI showed heterogeneous masses with long T1 and long T2 signals.After enhancement,the images of tumors were markedly enhanced.Because of the diversity of histological sources of tumors in this region,the tumors can be identified and diagnosed by some special imaging manifestations,such as fat,calcification,cystic degeneration and implant dissemination.Conclusion:The multi-axial imaging with enhanced scan of CT and MRI can clearly show the location,size,shape and edge characteristics of intracranial tumor,and it is helpful to locate and qualitatively diagnose pineal gland tumor.And the effect of differential diagnosis of MRI is better than that of CT.