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1、312临床放射学杂志2010年第29卷第3期头颈部放射学颅骨表皮样囊肿的CT及MRI特征*张丽红,张云亭,张敬,张权,孙志华摘要目的探讨颅骨表皮样囊肿(SEC)的CT和MRI影像学特点,以提高对该病的认识。资料与方法回顾性分析10例经手术病理确诊的SEC的CT及MRI表现。9例行CT平扫;8例行MRI检查,其中6例包含扩散加权成像(DWI)序列。8例MRI检查中2例行MRI平扫,4例行MRI平扫加增强检查,2例只行MRI增强检查;其中7例同时行CT及MRI检查。结果病变均为单发,起自板障。9例CT平扫示颅骨呈膨胀性改变,7例密度不均,
2、其中5例病变可见钙化;2例病变密度均匀。6例MRI平扫,4例呈以长T1、长T2为主混杂信号,1例呈均匀长T1、长T2信号,1例呈短T1、长T2信号。6例DWI序列中5例呈高信号,1例呈低信号;表观扩散系数(ADC)图重组后,1例呈稍高信号,1例呈高信号,4例呈稍低信号。6例MRI增强检查,2例病变无强化;4例病变内部和/或边缘强化,同时1例邻近硬膜明显强化。结论SEC的CT及MRI表现有一定的特征性,影像学检查有助于其定位及定性诊断。关键词颅骨表皮样囊肿体层摄影术,X线计算机磁共振成像CTandMRICharacteristicsofSkull
3、EpidermoidCystZHANGLihong,ZHANGYunting,ZHANGJing,eta.lDepartmentofRadiology,GeneralHospitalofTianjinMedicalUniversity,Tianjin300052,P.R.ChinaAbstractObjectiveTostudytheCTandMRfeaturesofskullepidermoidcyst.MaterialsandMethodsCTandMRIfindingsof10caseswithskullepidermoidcystsconf
4、irmedbysurgeryandpathologyweresummarizedandanalyzed.PlainCTscanswereperformedin9cases.MRIscanswereperformedin8cases,2patientsofwhichexaminedbyMRIplainscanand2examinedbycontrast-enhancedscan.4patientsexaminedbybothMRIplainscanandcontrast-enhancedscan.BothCTandMRIexaminationswereperf
5、ormedin7cases.ResultsAllcasesweresolitaryandexpansilelesions.OnCT,7casesdemonstratedinhomogeneousdensity,5ofwhichshowedcalcification.2casespresentedhomogeneousden-sity.4casesshowedheterogeneoushypointensityonT1-weightedimagingandheterogeneoushyperintensityonT2-weightedimaging.1cas
6、edemonstratedhomogeneouslylowsignalintensityonT1-weightedimagingandhighsignalintensityonT2-weightedimaging.1casepresentedhighsignalintensityonbothTandT-weightedimaging.Ondiffusionweightedima-12ging,5casesshowedhyperintensity,while1caseshowedhypointensity.1caseshowedmildhyperintensi
7、tyand1casepres-entedhyperintensityonADCmaps.Theother4casesdemonstratedmildhypointensity.OnenhancedT1-weightedimag-ings,2casespresentednoenhancementand4casesshowedenhancement.Thedurawasenhancedin1caseatthesametime.ConclusionCTandMRappearancesarehelpfulindiagnosisofskullepidermoidcy
8、st.KeywordsSkullEpider
