青少年幕上间变型室管膜瘤MR、CT影像学表现研究

MR and CT Imaging Manifestations of Juvenile Supratentorial Anaplastic Ependymoma

目的研究青少年幕上间变型室管膜瘤MR、CT影像学表现。方法回顾性分析本院2017年3月至2020年6月本院收治且经手术或病理确诊的18例青少年幕上间变型室管膜瘤的临床资料,观察病灶直径、位置、形态、周围水肿情况及增强表现。结果18例幕上室管膜瘤均位于脑实质,其中12例位于侧脑室旁。CT扫描显示了9个蔬菜状等密度肿瘤,9例呈混杂密度。7例呈散在沙粒样钙化,5例呈斑点状钙化。增强扫描的固态部分和囊壁呈现不均匀的中等增强。MR扫描T1WI呈等或稍低信号,T2WI呈高信号,4例瘤内出血,18例肿瘤周围可见水肿。增强扫描实性部分及囊壁呈中度不均匀强化,囊壁、周围血肿区及出血区域无明显强化。结论幕上间变型室管膜瘤的CT、MR表现具有一定特征性,囊变、出血、钙化、实性部分显著强化是其常见的影像学征象,结合患者临床特点可进一步对术前诊断提供帮助。

Objective To study the MR and CT imaging manifestations of juvenile supratentorial anaplastic ependymoma.Methods The clinical data of 18 juvenile with supratentorial anaplastic ependymoma who were admitted to this hospital from March 2017 to June 2020 and diagnosed by surgery or pathology were retrospectively analyzed.The diameter,location,shape,surrounding edema and enhancement characteristics of the lesion were observed.Results All the 18 cases of supratentorial ependymoma were located in the brain parenchyma,and 12 of them were located beside the lateral ventricle.CT scan revealed 9 vegetate-like isodense tumors,9 with mixed density.7 cases had scattered sand-like calcification and 5 cases had spotty calcification.The solid part and the cyst wall of the enhanced scan showed uneven and moderate enhancement.MR scan showed equal or slightly low signal on T1WI,high signal on T2WI.4 cases had intratumoral bleeding,and 18 cases had edema around the tumor.The solid part and the cyst wall of the enhanced scan showed moderately uneven enhancement.There was no obvious enhancement in the cyst wall,surrounding hematoma area and bleeding area.Conclusion The CT and MR findings of supratentorial anaplastic ependymoma have some characteristics.Cystic degeneration,hemorrhage,calcification,and significant enhancement of the solid part are common imaging signs.Combining the clinical characteristics of the patient can further help the preoperative diagnosis.