胼胝体肿瘤的CT和MRI表现

CT and MRI manifestations of corpus callosum tumors

目的探讨胼胝体肿瘤的影像学特征。方法回顾性分析经临床、病理确诊的95例胼胝体肿瘤临床资料和影像表现。结果肿瘤累及胼胝体嘴部2例,胼胝体膝部41例,胼胝体体部22例,胼胝体压部21例,累及胼胝体两个以上部位9例。95例中胶质母细胞瘤23例,肿瘤体积较大,可见明显坏死、出血,增强呈明显花环状强化;间变性星形细胞瘤17例,病灶信号欠均匀,1例DTI示肿瘤区白质纤维束破坏,增强呈轻度点片状强化或明显不规则环形强化;弥漫性星形细胞瘤10例,病灶信号均匀,增强无或轻度点片状强化;淋巴瘤17例,CT平扫为稍高密度,密度均匀,6例(6/7)1H-MRS可见高大Lip峰;2例(2/3)PWI为低灌注,增强呈明显团块状强化;少突胶质细胞肿瘤12例,CT平扫可见条状钙化,坏死、囊变常见,3例瘤内可见血管流空影,增强无强化或片状轻度至明显强化;转移瘤11例,肿瘤体积较小,病灶均为多发。室管膜瘤3例,肿瘤可见明显坏死、囊变,增强呈明显不规则环形强化;生殖细胞瘤2例,CT平扫为高密度,可见小囊变,增强呈明显团块状强化。结论胼胝体肿瘤特征性影像表现有助于诊断与鉴别诊断。

Objective To investigate the imaging features of corpus callosum tumors.Methods The clinical data and imaging findings of 85 cases of corpus callosum tumors confirmed by operation and pathology were retrospectively analyzed.Results Among the 85 cases,2 cases were involved in the rostrum of corpus callosum,41 cases in the genu,22 cases in the body,21 cases in the splenium,9 cases involving more than two parts of corpus callosum.There were 23 cases of glioblastoma in 95 cases with large size,obvious necrosis and hemorrhage.In 4 cases,small blood vessels were observed in the tumor,and the enhancement was marked with ring-shaped enhancement.In 17 cases of anaplastic astrocytoma,the signal intensity of the lesion was inadequate.One case showed white matter bundle destruction in the tumor area by DTI.The enhancement was slightly patchy or markedly irregular annular.There were 17 cases of lymphoma with slightly high density on CT scan.Diffuse astrocytoma in 10 cases showed homogeneous signal intensity with no or slight enhancement.Six cases(6/7)had high Lip peak on 1H-MRS and two cases(2/3)of PWI were hypoperfusion.The enhancement was markedly agglomerated.In 12 cases of oligodendroglial tumors,strip calcification,necrosis and cystic degeneration were common on CT scan.Vascular flow voids could be seen in 3 cases of oligodendroglioma.Metastases were found in 11 cases with small size and multiple lesions.Ependymoma was found in 3 cases.Hemorrhage,necrosis and cystic degeneration were common in the tumors.There were 2 cases of germinoma with high density,cystic changes and obvious mass enhancement.Conclusion The characteristic imaging findings of corpus callosum can be helpful for diagnosis and differential diagnosis.