100例髓母细胞瘤CT诊断分析.docVIP

100例髓母细胞瘤CT诊断分析 　 作者：王学仁 刘梅丽 王君贵 【摘 要】 目的 本文对100例髓母细胞瘤进行回顾性分析，结合临床病理以及MRI检查，探讨髓母细胞瘤的CT表现及其特点。方法 全部病人行常规CT扫描，发现病灶后行病灶局部层厚为2.0 mm薄层及增强CT扫描。其中65例经MRI检查。100例患者全部经手术及病理证实。结果 髓母细胞瘤90%发生于小脑蚓部，该部分患者年龄＜15岁。年长者与成人则常发生在一侧小脑半球（8.0%）。肿瘤血运丰富，可囊变、坏死（25.0%），偶有钙化（7.0%）。肿瘤生长速度快、病程短，平均病程为10周。其手术治疗不易完全切除，复发率高，1年、5年、10年生存率分别为82%、39%、12%。CT表现为肿瘤呈高或略高密度的肿块影，呈均一明显增强（75.0%），但是发生于小脑半球的肿瘤增强不明显（8.0%）。结论 髓母细胞瘤恶性度高、预后差，其CT表现有一定特征性，诊断的正确率为98%。 　　【关键词】 髓母细胞瘤；断层摄影术；X线计算机 　【Abstract】 Objective The CT images in 100 patients with medulloblastoma were retrospectively analyzed.Methods All the patients examined by the CT.Scanning the medulloblastoma by 2.0 mm slice thickness and contrastenhance,and 65 cases of them were examined by MRI scanning.All the patients were confirmed by surgery and pathology . Results The CT images showed that medulloblastorn was commonly seen in the children under the age of 15(90%),and it frequently situated at the inferiorwom of cerebellum,while in adults it involved the cerebellum hemisphere.The medulloblastorn was rich in blood supply.Cystic change or necrosis (25%) and occasional calcification (7%) were observed in these patients.Operation could not treat completely.The recurrence rate was high.The survival rates of 1 year,5 years and 10 years were 82%,39% and 12% respectively.The features of CT images on modulloblastoma showed high or slightly high attenuation with homogenious enhancement (75%).These were only 8% cases without obvious enhancement.Conclusion Medulloblastoma has a very high malignancy and poor prognoses.The CT images are specifically helpful in diagnosis of medulloblastoma.The accurate rate of diagnose is 98%. 　【Key words】 Medulloblastoma; Tomography;Xray computer 髓母细胞瘤是儿童常见的后颅凹恶性肿瘤，其术后复发率及病死率均较高。为了提高对本病的认识，现将我院1989年9月～1999年9月经手术及病理证实的100例髓母细胞瘤的CT与MRI及临床病理对照作综合分析。 1 材料与方法 1.1 一般资料 100例病人中，男74例，女26例。年龄2～36岁，平均14岁，其中＜10岁者72例，10～15岁者20例，＞15岁者8例。临床主要表现有头痛、呕吐94例，步态不稳、共济失调76例，视乳头水肿85例，外展神经麻痹27例，眼球震颤76例。病程2～32周。全部病人均行手术治疗，并跟踪观察。 1.2 影像学资料 采用美国Picker公司Premier