中枢神经系统神经上皮囊肿临床特征及其MRI鉴别诊断研究

Clinical Features of Neuroepithelial Cysts of Central Nervous System and Its Differential Diagnosis Value of MRI

目的研究中枢神经系统神经上皮囊肿临床特征及其MRI鉴别诊断价值。方法选取我院2017年2月至2020年3月收治且经手术病理证实的27例中枢神经系统神经上皮囊肿患者作为研究对象,观察病灶部位、直径、形态、MRI扫描信号、强化方式及病灶周围有无水肿等特征。结果 27例神经上皮囊肿中,两侧脑室后角8例,桥小脑角池3例,额叶2例;MRI扫描可见T_(1)WI上呈低信号,T_(2)WI上呈高信号,内部信号均匀,FLAIR序列呈低信号,囊壁较薄;DWI上囊内液体信号较脑脊液高,囊壁显示更为清晰,有明显占位效应。增强扫描无明显强化。骶管7例,T_(1)WI上呈低信号,T_(2)WI上呈高信号,增强扫描强化不明显。脉络膜裂囊肿7例MRI扫描T_(1)WI上呈低信号,T_(2)WI上呈高信号,FLAIR序列呈低信号;DWI上扩散无限制,边缘清晰,肿瘤直径<1.64cm。结论 MRI检查均有效显示中枢神经系统神经上皮囊肿的影像学特征,结合患者临床特征对比分析MRI征象可有效提高鉴别诊断准确率。

Objective To study the clinical features of neuroepithelial cysts of central nervous system and its differential diagnosis value of MRI.Method 21 patients with neuroepithelial cysts of the central nervous system who were admitted to our hospital from February 2017 to March 2020 and confirmed by surgery and pathology were selected as the research object.Features such as location of lesion,diameter,shape,signal of MRI scan,enhancement method,and edema around the lesion were observed.Results In the 27 neuroepithelial cysts,8 were located in the posterior horn of both sides of the ventricle,3 were in the cerebellopontine angle cistern,and 2 were in the frontal lobe.MRI scan showed low signal on T1 WI,high signal on T2 WI,uniform internal signal,low signal in FLAIR sequence,and ca psule wall was thin.The signal of intravesicular fluid on DWI was higher than that of cerebrospinal fluid,and the wall of the cyst was displayed more clearly and had a significant spaceoccupying effect.Enhanced scanning has no obvious enhancement.In 7 cases with sacral canal,there was a low signal on T1 WI and a high signal on T2 WI,and the enhancement scan was not obvious.In7 cases with choroidal fissure cyst,MRI scan showed low signal on T1 WI,high signal on T2 WI,and low signal on FLAIR sequence.DWI diffusion was unlimited,the edges were clear,and the tumor diameter was<1.64 cm.Conclusion MRI examinations can effectively display the imaging features of neu roepit h elial cysts of central nervous system.The clinical cha ra cteristics of patients a re combined to compa re and analyze MRI signs to effectively improve the accu ra cy of differential diagnosis.