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1、医学影像学杂志2005年第15卷第6期 JMedImagingVol.15No.62005髓母细胞瘤的MRI诊断及临床分析122莫友发,赵云辉,许乙凯(1.广东省东莞市虎门医院影像中心 广东 东莞 523902;2.南方医科大学南方医院影像中心 广东 广州 510515)【摘 要】 目的:分析髓母细胞瘤的临床特点、磁共振成像(MRI)征象及其诊断价值。方法:收集经手术与病理证实的髓母细胞瘤46例,全部病例均行MRI检查。结果:髓母细胞瘤主要临床表现为头痛、恶性、呕吐及行走不稳。肿瘤位于小脑蚓部42例,小脑半球4例。MRI上,病灶在T1WI为低信号者占81%(3
2、3/46),混杂信号者占19%(13/46);T2WI上为高信号者81%(33/46),混杂信号者占19%(13/46);Gd2DTPA增强扫描显示病灶呈均匀强化者占75%(34/46),不均匀强化者占20%(9/46),有5%(3/46)的病灶显示环状强化,瘤周有不同程度的水肿及伴有不同程度脑积水表现。MRI对髓母细胞瘤检出率、定位及定性诊断正确率分别为100%、96%、90%。结论:髓母细胞瘤的MRI表现具有一定特征性。MRI检查多方位、多序列成像,对其诊断、治疗及术后随访等有重要作用,因此髓母细胞瘤的检查应首选MRI。【关键词】 小脑肿瘤,髓母细胞瘤;磁
3、共振成像中图分类号:R739.41;R445.2 文献标识码:A 文章编号:1006-9011(2005)06-0449-03Medulloblastoma:theroleofMRIanditsclinicalanalysisMOYou2fa,ZHAOYun2hui,XUYi2kai.RadiologicalSection,HumenHospital,Dongguan,GuangdongProvince510515,China【Abstract】Objective:Thepurposesofthisstudyweretoanalyzeclinicalc
4、haracteristicanditssignsonimagesofmagneticresonanceimaginganddiagnosisvaluesofMRI.Methods:Therewereforty2sixpatientswithmedulloblastoma.Thediagnosisofallpatientshadcon2firmedbyoperationandpathology.Inthesepatients,themalewerethirty2threeandthefemalewerethirteen.Theageofthesepatients
5、rangedfromfivetoforty2twoyearsold,meanthirteenyearsold.AllpatientshadcheckedbyMRI.Results:Themainclinicalmanifesta2tionsofmedulloblastomawereheadache,nausea,vomitandinstablewalk.Thetumorlocatedvermisofcerebelluminforty2twopatients,andlocatedcerebellarhemisphereinfourpatients.Inthese
6、patients,malechildrenweremajority.OnMRI,inforty2sixpatients,tumorswerelow2signal2intensityinthirty2threepatients(81%)andwereintermixsignalintensityinthirteenpatients(5%)onT12weightedim2ages;tumorswerehigh2signal2intensityinthirty2threepatients(81%)andwereintermixsignalintensityinthi
7、rteenpatients(5%)onT22weightedimages;afterinjectingGd2DTPA,thetumorsinthirty2fourpatientswereshowedhomogeneousenhancementandinninepatientswereheterogeneousenhancement,therewerethreepatientsthattheirtumorswereshowedcircularenhancement.Insomepatients,thetu2morswereoccurredcysticchange
8、,hemorrhage,calcifi