小脑血管母细胞瘤的CTMRI诊断.docVIP

小脑血管母细胞瘤的CT、MRI诊断 【摘要】 目的 探讨小脑血管母细胞瘤的CT和MRI表现，以提高诊断水平。方法 对39例经过手术病理证实的小脑血管母细胞瘤进行影像学分析，所有病例均行MRI平扫及增强扫描，25例行CT扫描。结果 21例均单发生于右侧，18例发生于左侧，大囊小结节35例，单纯囊肿型3例，完全实型1例；直径lt;5.0cm26例，gt;5.0 cm 13例。肿块大多无包膜，形态呈类圆形，增强扫描囊腔及囊壁不强化、壁结节明显强化，各种病变均有一定的影像表现特点。 结论 熟悉小脑血管母细胞瘤的形态及强化特点，对于诊断与鉴别诊断有重要价值。 【关键词】 磁共振；体层摄影术，X线计算机；小脑血管母细胞瘤 ［Abstract］Objective To explore the CT and MRI manifestations of hemangioblastoma of cerebellum.Methods The CT and MRI findings of 39 cases with hemangioblastoma of cerebellum, proved by operation and pathology, were analyzed retrospectively.All cases were scanned with conventional plain and postcontrast MR sequences. CT examinations were performed in 25 cases. Results Lesions were located in right(21 cases) or left(18 cases) hemispherium cerebelli. 35 cases were large cyst-small nodule type , 3 cases simple cyst type ,and 1 case was purely solid mass type.The tumors was less than 5.0cm in diameter in 26 cases and more than 5.0cm in diameter in 13 cases. Most of the masses were without capsule and round-like in shape. After enhanced scan, the nodules showed marked intensification while the cyst and the wall showed non-intensification.The imaging findings of lesions of various kinds had some characteristics. Conclusion It is most important to be familiarized with the characteristics of the shape and intensification of hemangioblastoma of cerebellum for the diagnosis and differential diagnosis. ［Key words］magnetic resonance imaging；tomography；X-ray computed；hemangioblastoma of cerebellum 小脑血管母细胞瘤主要是类似毛细血管的纤维血管，细胞成分包括内皮细胞、外皮细胞和间质细胞，因其内含有丰富的网状纤维为特征，故也称为血管网状细胞瘤。 资料与方法 搜集2004年03月～2007年10月经CT、MRI检查血管母细胞瘤39例，男性21例，女性18例，年龄16-48岁，中位年龄31岁，，大囊小结节35例，单纯囊肿型3例，完全实型1例；直径lt;5.0cm26例，gt;5.0cm13例。临床表现主要包括头疼、眩晕、呕吐、眼球震颤侧距不良症状等。 CT机采用GE Lightspeed 16螺旋CT扫描仪。25例行CT扫描。使用高压注射器由肘部静脉注入欧乃派克-300mg/ml，80～100ml速率2.5ml/s。磁共振扫描仪采用GE Signa 1.0T超导型磁共振机，MRI采用头部线圈，所有病例除平扫外均行钆喷替酸葡甲胺（Gd-DTPA）增强扫描。 结 果 大囊小结节35例，年龄20～48岁，平均35岁， 28例CT平扫囊性部分呈均质低密度，CT值5-10Hu，7例因出血CT值偏高，壁结节均小，直径约8mm-12mm；MR 壁结节T1加