颅内表皮样囊肿的影像学诊断

临床应用¬颅内表皮样囊肿的影像学诊断

宋爱芹,　李文武,　李万湖,　陈兆秋,　候栋梁

山东省肿瘤医院CT室,山东济南250117

Imaging diagno sis of intracranial epidermoid cysts

S O N G A i2qin,L I Wen2w u,L I W an2hu,C H EN Zhao2qi u,HOU Dong2liang

C T Room of S handong T umor Hos pital,J inan250117,P.R.China

【摘要】　目的:分析颅内表皮样囊肿的CT 和MRI表现。方法:对30例经手术及病理确诊的颅内表皮样囊肿的CT和MRI表现作回顾性分析,其中30例作MRI平扫与增强扫描;20例作CT平扫检查。结果:肿瘤位于桥前池及桥小脑角池18例,4例位于鞍上,2例位于鞍旁,5例位于第四脑室,1例位于小脑延髓池。肿瘤大小不等,形态不规则,轮廓光整或呈分叶状。CT平扫17例呈均匀低密度,2例呈稍不均匀低密度,CT值为-15～10Hu,1例呈高密度。MRI平扫28例T1加权像上肿瘤呈不均的低信号,T2加权像上呈不均匀高信号,部分病例在FLAIR图象上表现为不均匀高信号,与周围低信号的脑脊液分界清晰;2例表现为T1加权像上为高信号,T2加权像上为低信号。增强后,2例肿瘤边缘有轻微强化,其余肿瘤均无明显强化。结论:典型的颅内表皮样囊肿,通过CT和MRI检查可做出准确诊断,并可以与颅内其他疾病相鉴别;在鉴别诊断中,MRI优于CT。非典型的颅内高密度囊肿,必须CT 和MRI相结合诊断,为准确的术前诊断提供更多的信息。

中华肿瘤防治杂志,2006,13(8):621-623[ABSTRACT]　OB JECTIVE:To analyze the features of intracranial epidermoid cysts on CT and MR imagings.METH ODS:Thirty pa2 tients with intracranial epidermoid cysts proven surgically and patho2 logically were examined with pre2and post2contrast enhanced MR im2 aging,and20of30patients also undergone CT plain scan.CT and MR imagings of30cases were retrospectivelly reviewed.RESU LTS: Among thirty cases,18were located in the cisterns of cerebell opon2 tine angle,4in the suprasellar,2in the parasellar region,5in the fourth ventricles and1in the cerebellomedullar cistern.The tumors were different in size and had irregular shapes,the contours were lobulated or smooth.On CT,17cases were homogeneous hypodense, 2slightly inhomogeneous hypodense f rom-15to10Hu in CT val2 ues.1cases was hyperdense.Twenty2eight of30imaging cases dem2 onstrated inhomogeneous hypointensityimaging on T1WI,and inho2 mogenous hyperintensity on T2WI.Partial cases demonstrated inho2 mogenous hyperintensity.The border was clear between the tumors and the cerebrospinal fluid.Only2cases demonstrated hyperintensity on T1WI and hypointensity on T2WI.No contrast enhancement was noted except2cases with slightly periphery enhancement.CONC L U2 SION:The typical intracranial epidermoid cysts could be diagnosed accurately and differentiated f rom other similar cystic lesions with CT and MR imagings.MRI is superior to CT in differential diagnosis. Untypical intracranial epidermoid cysts should be diagnosed correla2 ting CT with MRI,providing more data before operation.

Chin J Cancer Prev T reat,2006,13(8):621-623

【关键词】　表皮样囊肿;体层摄影术,X线计算机;磁共振成像

[KE YWOR DS]　epidermoid cysts;tomography,X2ray computed;magnetic resonance imaging

【中图分类号】　R739.41;R730.44 【文献标识码】　A 【文章编号】　1673-5269(2006)08-0621-03

颅内表皮样囊肿是临床少见的先天性胚胎性肿瘤,约占颅内原发肿瘤的012%～118%[1],随着CT和

【第一作者简介】　宋爱芹,女,山东即墨人,硕士,主要从事肿瘤影像诊断学的研究工作。

Tel:86-531-87984777-82272

【通讯作者简介】　李文武,男,山东蓬莱人,研究员,硕士生导师,主要从事肿瘤的影像诊断学的研究工作。

Tel:86-531-87984777-82283MRI广泛应用于临床,对表皮样囊肿的影像学表现认识有了明显的提高,诊断准确性也有很大的提高。我们收集资料完整并经手术病理确诊,且行CT和MRI 检查的30例颅内表皮样囊肿的病例,以探讨CT和MRI诊断颅内表皮样囊肿的价值。

1　对象与方法

1.1　病例选择及一般资料

收集我院30例自1995年6月～2004年12月经

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中华肿瘤防治杂志2006年4月第13卷第8期 CHIN J CANCER PREV TREA T,April2006,Vol.13　No.8