硬膜浆细胞瘤的MR诊断.ppt

OverviewDuralplasmacytomasareuncommonextramedullaryplasmacelltumorsthatshouldbeconsideredinpatientswithaduralmassandhistoryofplasmacelldyscrasia.硬脑膜浆细胞瘤是一种不常见的髓外浆细胞肿瘤，当病人有浆细胞性恶液质病史，出现硬膜肿块时需要考虑到本病的可能。Onlyseeasmallnumberofreportedliterature国内外文献仅见少数报道Andproposedthefollowingdiagnosticcriteria并提出如下诊断标准①nootherboneinvolvementinx-rayX线无其它骨受累②Mustbeconfirmedhistologically必须有组织学证实③Bonemarrowbiopsynegative骨髓穿刺阴性④NotProteinuria,hyperlipidemia无高蛋白血症和本周蛋白尿74-year-oldfemalewithhistoryofheadache.74岁女性，头痛。Case章节一isointensesignalonTIrelatively在T1序列上呈相对的等信号isointensesignalonT2relatively在T2序列上呈相对的等信号增强T1WI横轴位Thelesiondemonstrateshomogeneouscontrastenhacement增强T1WI冠状位ThelesiondemonstrateshomogeneouscontrastenhacementinCoronalThereisanextra-axial,duralbasedmasspredominantlyinthehighleftposteriorparietalregionwhichisrelativelyisointensesignalonTIandT2sequences.图示左侧后顶部的以脑膜为基底的脑外肿块，在T1和T2序列上呈相对的等信号。Thelesiondemonstrateshomogeneouscontrastenhacementonpostcontrastsequences,(yellowarrowinFigure3).Extensionalongtheinterhemisphericfissure(yellowarrowinFigure4),encasementofthesuperiorsagittalsinus(redarrowinFigure4)andextensionacrossmidlinetotheright(bluearrowinFigure4)isdemonstrated.病变显示明显的强化（图3、黄箭），病变沿大脑纵裂扩展（图4、黄箭），包埋上矢状窦（图4、红箭）和沿中线扩展至右侧（图4、蓝箭）34emphasisDifferentiationbetweenthesolitaryformandplasmacytomainassociationwithmultiplemyelomahasimportanttreatmentimplications.区别是孤立性浆细胞瘤还是多发性骨髓瘤相关的浆细胞瘤对于治疗有重要的意义。Imagingcharacteristicsofduralplasmacytomasmaycloselyresemblethoseofmeningiomas.硬膜浆细胞瘤的影像特征与脑膜瘤非常相似。Thelatterisusuallyaccompaniedbymultiplelyticlesionsoftheskull.后者通常伴有颅骨多发性囊性病变。Plasmacytomasoftheduralareuncommonplasmacelltumorsthatmayoccurasasolitaryneoplasmmorecommonly,inassociationwithmultiplemyeloma.孤立性的硬膜浆细胞瘤是不常见的，而多发性骨髓瘤相关的浆细胞瘤相对更常见些。Indistinction,sol