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为了探讨磁共振成像(MR)对儿童后颅窝肿瘤的诊断与鉴别诊断价值及儿童后颅窝肿瘤误诊原因,回顾性分析48例误诊的儿童后颅窝肿瘤的MR和临床资料,其中星形细胞瘤18例、髓母细胞瘤15例、室管膜瘤7例、胚胎发育性神经上皮瘤5例、血管母细胞瘤3例。肿瘤位于小脑蚓部20例,小脑半球14例,脑干9例,第四脑室5例。所有病灶均引起梗阻性脑积水。MR能显示肿瘤的位置、大小、形态及信号特点,定性诊断明显优于CT。初步研究结果提示,儿童后颅窝肿瘤的MR表现具有一定的特征性,对定位和定性诊断具有重要的临床应用价值,患儿不典型的症状与体征以及未及时行头颅MR检查是延误诊断的主要原因。
To investigate the value of magnetic resonance imaging (MR) in the diagnosis and differential diagnosis of posterior fossa tumors in children and the causes of misdiagnosis of posterior fossa tumors in children, retrospective analysis was made on the MR and clinical data of 48 cases of misdiagnosed posterior fossa tumors. Among them, 18 cases of cell tumor, 15 cases of medulloblastoma, 7 cases of ependymoma, 5 cases of embryonic developmental neuroepithelioma and 3 cases of hemangioblastoma. The tumors were located in cerebellar vermis in 20 cases, cerebellar hemisphere in 14 cases, brain stem in 9 cases and fourth ventricle in 5 cases. All lesions cause obstructive hydrocephalus. MR can show the location of the tumor, size, shape and signal characteristics, qualitative diagnosis was significantly better than CT. Preliminary findings suggest that the MR manifestations of posterior fossa tumors in children have certain characteristics, which have important clinical application value in the diagnosis of posterior fossa, and atypical symptoms and signs in children, as well as the delayed diagnosis of MR main reason.