颅内脂肪瘤稿.docVIP

颅内脂肪瘤的磁共振表现 舒锦尔 章士正 李惠民 盛三兰 卢金花 蒋春景 吴海林 目的：分析颅内脂肪瘤MRI影像特点并探讨其发生机制。材料和方法：58例颅内脂肪瘤(2例手术证实，其余依据典型短T1中长T2和高质子密度的MR信号和抑脂信号消失而诊断)，其余依据典型纯脂肪信号确定诊断进行MRI影像分析，男28例，女30例，年龄41.3(9-77)岁。均采用常规SE序列，T2WI加脂肪抑制，行横断位矢状位冠状位扫描，其中4例使用了T1WI脂肪抑制。结果：全部病灶均具有典型MR信号，并均无占位效应。中线脂肪瘤41例，合并发育异常9例；其中胼胝区16例，包括巨块3例，弧线型12例，小点状1例。四叠体池、环池区域13例，小脑上池6例，窦汇区、蚓部、纵裂内、小脑半球间、鞍上池、跨枕大孔区各1例。非中线脂肪瘤15例。包括天幕池2例，桥小脑角池、侧裂池、侧脑室三角区各4例，及脑实质1例。多发伴OPCA2例，分别为2个和4个瘤体。结论：颅内脂肪瘤具有典型MR信号，中线部位尤其胼胝体区多见，并常见伴行的发育异常；非中线部位表现多样，形态各异，伴行发育异常较少；少数可多发。胼胝体区脂肪瘤具有较强规律性，与胼胝体发生发育一致。 关键词：颅内脂肪瘤 磁共振成像 MR findings of intracranial lipoma Shu Jin-er, Zhang Shizheng, Li Huimin, et al. Department of Radiology, Sir Run Shaw Hospital, Affiliated to Medical Collge of Zhejiang University, Hangzhou 310016 Purpose: To analyse the featrues of intracranial lipoma and explore its genesis. Materials and Methods: We reviewed 58 cases(28 male and 30 female, mean age 41.3 years between 9 and 77) of intracranial lipoma diagnosed by MR imaging(n=56) and surgery(n=2). The routine SE sequence and fat-suppressed technique were used in all examination. Results: The typical MR signal was seen in all patients without mass effect. 41 lipomas were at the midline which had 16 pericallosal lipoma showed mass(3), arc-like(12) and dotted(1),,and 9 of them were combined with dysplasia. 15 patients had a lipoma not at the midline and 2 patients had multiple lesions. Conclusion: The intracranial lipoma had typical MR signal and usually located at pericallosal region and accompanied with dysplasia. There also were diverse lipomas beyond the midline. The pericallosal lipoma would be in order, which was accordance with development of the corpus callosum. Keywords: Intracranial lipoma MRI 310016浙江大学医学院附属邵逸夫医院放射科(舒锦尔 章士正) ；第二军医大学附属长征医院影像科(李惠民)；浙江省金华市中心医院放射科(盛三兰)  WHO(2000年)神经系统肿瘤分类中，颅内脂肪瘤归类于脑膜间质非脑膜上皮细胞肿瘤，这种广义的脂肪组织良性肿瘤共有4种，即：脂肪瘤，血管脂肪瘤，冬眠瘤和畸形变型。临床上的病例一般为畸形变型，即不是一种真性肿瘤，因没有新生物的生物学特性；原始脑膜在胚胎时期逐渐被吸收并演变成蛛网膜下腔，如原始脑膜残留并分化成脂肪，就形成位于蛛网膜下腔的脂肪瘤。较大肿瘤内常有血管和神经组织交织在一起，往往含有一些血管和纤维组织，血管较多时即为血管脂肪瘤