ISSN 1004-4140
CN 11-3017/P

不同部位室管膜瘤MRI特征的对比分析

Comparing Features of Different Location of Ependymomas on MR Imaging

  • 摘要: 目的 对比分析不同部位室管膜瘤的年龄分布及其MRI特征。 材料和方法 回顾性分析经病理证实的58例室管膜瘤,所有患者均行了MRI平扫和增强扫描,分析患者的年龄分布并在MRI图像上观察肿瘤大小、位置、生长方式、信号特点,有无囊变和出血及肿瘤的强化方式。 结果 58例室管膜瘤中,27例(46.6%)位于幕上,患者年龄大部分分布在30-50岁之间,侧脑室占20例;20例(34.5%)位于幕下,年龄分布多在20岁以前,绝大多数位于四脑室;11例(18.9%)位于脊髓内。不同部位室管膜瘤信号特征无明显差异性,96.3%幕上、95%幕下、45.5%室管膜瘤呈不均匀显著强化,70.4%幕上、55%幕下、18.2%脊髓室管膜瘤可见瘤内囊变,45.5%的脊髓室管膜瘤可见脊髓本身继发性囊变。29.6%幕上、20%幕下及9%脊髓室管膜瘤可见瘤内出血。80%侧脑室肿瘤侵及对侧侧脑室,四脑室室管膜瘤中,16例沿着侧脑室正中孔浸润,12例通过外侧孔累及桥小脑角,全部脊髓室管膜瘤沿脊髓长轴中心性生长,1例终丝室管膜瘤合并有椎间孔扩大。 结论 不同部位室管膜瘤在好发年龄、囊变及强化方式存在着差异,可塑性生长是脑室内室管膜瘤的显著特征,了解这些差异有助于术前正确诊断。

     

    Abstract: Objective: To compare the age distribution and characteristic MR imaging findings of ependymomas for each typical location. Materials and Methods: 58 cases of ependymomas with histologically confirmed were retrospectively reviewed in terms of age distribution,location,size,pattern of growth,signal intensity,the presence or absence of cyst and hemorrhage as well as enhancement pattern on MR imaging. Results: Among the 58 patients,supratentorial ependymomas were 27(46.6%) cases,and the age distribution of most cases was between the third and fifth decade,20 cases of supratentorial ependymomas lie in lateral cerebral ventricle.Infrartentorial tumors were 20(34.5%)cases,and the age distribution of cases was before the second decade,almost of infrartentorial tumors lie in the fourth ventricle.Spinal cord ependymomas were 11(18.9%).The signal intensity of the ependymomas was non-specific,regardless of their location.A cystic component was seen in 70.4% of supratentorial,55% of infratentorial,and 18.2% of spinal cord ependymomas.The spinal cord ependymomas which were associated with reactive cysts were 45.5%.Intratumoral hemorrhage occurred in 29.6% of supratentorial,20% of infratentorial,and 9% of spinal cord tumors.Eighty percent of lateral cerebral ventricle ependymomas extended to opposite side ventricle,In fourth ventricle,16 cases of tumors extended caudally via Magendie foramen,and 12 cases into the cerebellopontine angel through the foramen of Luschka.All spinal cord ependymomas showed epicentral growth,and intervertebral foramina enlarged was displayed in one case of filar ependymomas. Conclusion: Ependymomas for each typical location have differential in age distribution,cystic component and enhancement pattern.Desmo-plastic development(plasticity growth) is significant feature of cerebro-ventricular ependymomas.Awareness of these difference is in favor of correct preoperative diagnosis.

     

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