脑室占位病变的影像表现分析及鉴别诊断

Imaging Features and Differential Diagnosis of Ventricular Mass Lesions

目的通过搜集并分析脑室内占位性病变的类型及其CT、MRI表现,理顺其诊断及鉴别诊断思路,以提高我们对脑室占位病变的影像诊断水平。方法回顾性分析了我院2013年1月2022年4月经手术病理证实的不同部位的脑室占位病变患者27例。根据病变实质的疏密分成三型:密实型、疏松型及囊性型;统计并分析各病变的其部位、大小、形态、实质的疏密、囊变、钙化、出血、脑积水等影像表现。结果27例病变中2例表皮样囊肿为无实质成分的囊性型;4例中枢神经细胞瘤和3例脉络丛乳头状瘤均为部分实质疏松的疏松型;密实型包括其它的脑膜瘤、室管膜瘤、胶质母细胞瘤等共18例。另外脑室占位病变以脑膜瘤最常见(8/27),其中脑膜瘤多见于侧脑室(7/8),中枢神经细胞瘤大部分发生在侧脑室透明隔区(5/6),室管膜瘤多见于第四脑室(3/4)等。不同的脑室占位病变有其常见的影像表现。结论各种脑室内占位病变有其好发部位;根据病变实质疏密不同的三种分型,结合各病变的CT/MRI影像表现,可以有效提高我们的影像诊断准确率。

Objective To improve the imaging diagnosis of ventricle occupying lesions by collecting and analyzing the types of ventricle occupying lesions and their CT and MRI manifestations,so as to rationalize their diagnosis and differential diagnosis.Methods A total of 27 patients with different ventricular occupying lesions confirmed by surgery and pathology in our hospital from January 2013 to April 2022 were retrospectively analyzed.According to the density of the lesion parenchyma,it is divided into three types:dense type,loose type and cystic type;The location,size,shape,parenchymal density,cystic degeneration,calcification,hemorrhage,hydrocephalus and other imaging manifestations of each lesion were statistically analyzed.Results Of the 27 cases,2 cases of epidermoid cysts were cystic without parenchyma.4 cases of central neurocytoma and 3 cases of choroid plexus papilloma were loose type with loose parenchyma.The dense type included other meningiomas,ependymoma and glioblastoma in 18 cases.In addition,meningioma was the most common lesions(8/27),among which meningioma was more common in the lateral ventricle(7/8),central neurocytoma was mostly in the septum pellucidum of the lateral ventricle(5/6),ependymoma was more common in the fourth ventricle(3/4),etc.Different ventricular lesions have their common imaging manifestations.Conclusion There are some common sites in various kinds of intraventricular lesions.According to the three types of different parenchyma density of lesions,combined with the CT/MRI imaging manifestations of each lesion,we can effectively improve the accuracy of imaging diagnosis.