肿块样原发性中枢神经系统血管炎的磁共振表现

郑奎宏; 马林; 史丽静; 郭勇; 黄敏华; 张燕群; 赵书臣

中国临床医学影像杂志 ›› 2010, Vol. 21 ›› Issue (11) : 761-764.

论著

肿块样原发性中枢神经系统血管炎的磁共振表现

郑奎宏1，马林2，史丽静1，郭勇1，黄敏华1，张燕群1，赵书臣1

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MR imaging findings of the tumor-mimicking primary angiitis of the central nervous system

ZHENG Kui-hong1, MA Lin2, SHI Li-jing1, GUO Yong1, HUANG Min-hua1, ZHANG Yan-qun1, ZHAO Shu-chen1

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摘要

目的：描述肿块样原发性中枢神经系统血管炎的MRI表现，探讨该病变的MRI诊断价值。方法：对进行了MR检查的8例经活检病理证实的肿块样原发性中枢神经系统血管炎的MR影像学表现特征进行了回顾性分析。结果：MRI显示6例表现为单发局限性肿块；2例表现为多发肿块。3例呈均匀长T1信号，5例呈短T1及长T1混杂信号；3例呈均匀长T2信号，5例呈不均匀长T2信号。全部8例经钆喷替酸葡甲胺（Gd-DTPA）增强，病灶均有明显强化。所有8例患者的全部病变均呈团块样强化。结论：肿块样原发性中枢神经系统血管炎影像学诊断较困难，MR检查常将本病误诊为肿瘤。认识其MRI表现特点有助于诊断该疾病，以避免手术造成的严重损伤，但最终确诊仍需脑活检。

Abstract

Objective: To describe the MRI features of the tumor-mimicking primary angiitis of the central nervous system(PACNS) and to discuss MR diagnostic value of the tumor-mimicking PACNS. Materials and Methods: Eight patients with biopsy-proven PACNS mimicking brain tumor underwent MRI were reviewed. The findings of MR imaging were retrospectively analyzed and the clinical symptoms were also analyzed. Results:　MR imaging demonstrated solitary mass in 6 cases, and multiple mass in 2 cases. On T1WI, the lesions showed homogeneous low signal in 3 cases, and mixed high and low signal in 5 cases. On T2WI, the lesions presented as homogeneous high signal in 3 cases and inhomogeneous high signal in 5 cases. All 8 cases with Gd-DTPA administration, marked enhancement was seen. All lesions of 8 cases showed mass-like enhancement. Conclusion: It is a difficult task to make the correct diagnosis of the tumor-mimicking PACNS, and this disease entity is often misdiagnosed as tumor by MRI. The comprehensive understanding of the MRI characteristic features would be helpful in diagnosing the tumor-mimicking PACNS, thus avoiding the devastating injury caused by surgery. The definite diagnosis relies on brain biopsy.

导出引用

郑奎宏;马林;史丽静;郭勇;黄敏华;张燕群;赵书臣. 肿块样原发性中枢神经系统血管炎的磁共振表现[J]. 中国临床医学影像杂志. 2010, 21(11): 761-764

ZHENG Kui-hong;MA Lin;SHI Li-jing;GUO Yong;HUANG Min-hua;ZHANG Yan-qun;ZHAO Shu-chen. MR imaging findings of the tumor-mimicking primary angiitis of the central nervous system[J]. Journal of China Clinic Medical Imaging. 2010, 21(11): 761-764

中图分类号： Ｒ742 Ｒ445.2