摘要
目的：探讨儿童幕上脑室内占位性病变的影像诊断价值。方法：回顾性分析经手术病理证实的45例儿童幕上脑室占位性病变的临床及影像资料。男25例，女20例，年龄4月~13岁，中位年龄2岁。结果：脉络丛乳头状瘤16例，边缘呈颗粒状或分叶状，CT表现为稍高密度，MRI表现为T1WI呈等、低信号,T2WI等、高信号，DWI等低信号，增强后明显强化。非典型脉络丛乳头状瘤6例，1例散在斑点状钙化，2例伴脑脊液播散，2例伴周围脑组织水肿。脉络丛癌1例，呈囊实性，DWI呈高信号。毛细胞型星形细胞瘤4例，毛细胞黏液样星形细胞瘤2例，均位于三脑室，DWI稍低信号，增强明显强化。室管膜瘤2例，非典型畸胎样/横纹肌样瘤2例，室管膜下巨细胞星形细胞瘤1例，脑膜瘤1例。神经上皮囊肿10例，囊壁菲薄，囊液信号与脑脊液信号相似，增强扫描无强化。结论：儿童幕上脑室占位性病变的病理类型复杂，CT和MRI基本能反映肿瘤的特点，结合临床资料，可对大部分病例作出定性诊断。
Abstract
Objective: To explore the value of imaging diagnosis of supratentorial ventricular masses in children. Methods: Forty-five cases(25 males, aged from 4 months to 13 years with a median age of 2 years) of supratentorial ventricular masses in children confirmed by pathology were analyzed retrospectively. Results: Sixteen cases were choroid plexus papillomas, which appeared as lobulated or granular-countered masses. They were hyperattenuating on CT, iso- to hypointense on T1WI, iso- to hyperintense on T2WI and iso- to hypointense on DWI. Contrast-enhanced imaging showed avid enhancement. Six cases were atypical choroid plexus papillomas with the appearance of small calcifications(n=1), CSF spreading(n=2) and peritumoral edema(n=2). One case was choroid plexus carcinoma, which was solid-cystic with hyperintensity on DWI. Four cases were pilocytic astrocytoma, and 2 cases were pilomyxoid astrocytoma. They were located in the third ventricle, with hypointensity on DWI and intense enhancement. Two cases were ependymomas. Two cases were atypical teratoid/rhabdold tumors. One case was subependymal giant cell tumor. One case was meningioma. Ten cases were neuroepithelial cysts, which showed a thin cyst wall. They showed similar intensity to CSF and no enhancement. Conclusion: The types of the supratentorial ventricular masses in children are varied. CT and MRI can reflect certain characteristics of the masses in this region. With the help of clinical and imaging findings, the diagnosis can be drawn in most cases.
关键词
脉络丛肿瘤 /
儿童 /
体层摄影术 /
X线计算机 /
磁共振成像
Key words
Choroid plexus neoplasms /
Child /
Tomography /
X-ray computed /
Magnetic resonance imaging
杨 飘;李美蓉;李玉华.
儿童幕上脑室占位性病变的影像学诊断价值[J]. 中国临床医学影像杂志. 2015, 26(3): 153-156
YANG Piao;LI Mei-rong;LI Yu-hua.
Imaging diagnosis of supratentorial ventricular masses in children[J]. Journal of China Clinic Medical Imaging. 2015, 26(3): 153-156
中图分类号：
Ｒ739.41
R814.42
Ｒ445.2
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