成人颅内毛细胞型星形细胞瘤的MRI表现

MRI findings of intracranial pilocytic astrocytoma in adults

目的分析成人颅内毛细胞型星形细胞瘤(PA)的MRI表现并文献复习。方法回顾性分析海南省人民医院2003年12月至2017年12月期间经手术病理证实的7例成人颅内PA患者的影像学资料,男性5例,女性2例,中位年龄35岁。结果4例位于小脑,额叶、侧脑室及视神经(颅眶沟通)各1例;MRI表现:4例囊结节型,2例囊肿型,1例实质型;病灶实性部分T1WI呈等或稍低信号,T2WI呈稍高信号,囊变、坏死部分呈长T1长T2信号,增强扫描实性部分呈不均匀的轻度-明显强化,囊壁及囊性部分无强化;其中1例伴瘤内出血,3例伴瘤周轻度水肿。结论成人颅内出现壁结节呈明显强化的囊结节型肿块及囊壁呈轻度或无强化的囊性肿块时,应考虑PA可能;对于颅内实性肿块,鉴别诊断较难,最终靠病理确诊。

Objective To analyze the MRI findings and literature review of intracranial pilocytic astrocytoma(PA)in adults.Methods The imaging data of 7 adults with intracranial PA confirmed by surgery and pathology from December 2003 to December 2017 in Hainan General Hospital were retrospectively analyzed,including 5 males and 2 females,with a median age of 35 years.Results Four cases were located in cerebellum,and 1 case each in frontal lobe,lateral ventricle and optic nerve(cranio-orbital tumor).The MRI findings showed 4 cases of cystic nodule type,2 cases of cystic type and 1 case of parenchymal type.The T1 WI of the solid part of the lesion showed equal or slightly lower signal,the T2 WI showed slightly higher signal,the cystic T1 necrotic part showed long T1 and long T2 signal,the enhancement scan solid part showed uneven mild-obvious enhancement,with the cystic wall and cystic part had not strengthen.There was 1 case was intratumoral hemorrhage,and 3 cases with mild peritumoral edema.Conclusion The possibility of PA should be considered when the wall nodule with obvious enhancement and the wall with slight or no enhancement appear in the adult brain.For intracranial solid mass,differential diagnosis is more difficult,and the final diagnosis depends on pathology.