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目的分析青少年幕上脑实质室管膜瘤的CT及MRI影像表现特点,研究其与病理分级的相关性,以提高CT、MRI在青年室管膜瘤中的应用价值。方法筛选幕上脑实质室管膜瘤患者42例作为研究对象。所有患者均经手术及病理证实为幕上脑实质室管膜瘤,术前行MRI、螺旋CT平扫及增强扫描。结果 42例患者中Ⅱ级者10例,Ⅲ级者32例,CT及MRI影像学检查明确Ⅱ级者8例,Ⅲ级者28例,另有4例无法确定,影像学检查分级评价结果与病理检查结果比较无显著差异,不具有统计学意义(P>0.05);CT及MRI影像中,42例均为颅内囊实性占位病变,其中25例囊变位于病灶周边。MRI示42例病灶囊性部分呈长T1与长T2表现,实性为不均匀等T1、等T2信号,DWI表现为中高信号;CT检查实性病变为稍高密度,增强扫描33例呈不均匀及分房分隔样强化,9例实性部分强化较均匀,囊壁均可见环形强化;脑水肿影像评估无明显水肿及轻度16例,中度10例,重度15例,表示脑水肿及水肿程度与病理分级并无相关性,不对病理分级产生影响。结论幕上脑实质室管膜瘤患者术前行CT及MRI检查对评估其病理分级及具体病情具有一定意义,对临床手术治疗具有指导价值。
Objective To analyze the CT and MRI features of the supratentorial supratentorial ependymoma and to study the correlation with the pathological grade in order to improve the application value of CT and MRI in young ependymoma. Methods Screening of supratentorial parenchymal ependymoma patients as the study object. All patients were confirmed by surgery and pathology of supratentorial parenchyma ependymoma, preoperative MRI, spiral CT plain and enhanced scan. Results Of the 42 patients, 10 were grade Ⅱ and 32 were grade Ⅲ. CT and MRI imaging revealed 8 of grade Ⅱ, 28 of grade Ⅲ, and 4 of them could not be determined. The results of radiographic evaluation There was no significant difference between the pathological examination results (P> 0.05). In CT and MRI images, 42 cases were intracapsular saccular space occupying lesions, of which 25 cases cystic lesions located in the periphery of the lesion. MRI showed 42 cases of cystic lesions showed long T1 and long T2 performance, the actual non-uniform T1, T2 signal, DWI showed high signal; CT examination of solid lesions to a slightly higher density, enhanced scan was not present in 33 cases Uniform and sub-room separation enhanced, 9 cases of solid part of the more uniform, cystic wall can be seen ring-shaped enhancement; no significant edema in brain edema and mild imaging in 16 cases, 10 cases of moderate and severe in 15 cases, indicating that brain edema and The degree of edema has no correlation with pathological grade, and does not affect the pathological grade. Conclusion The supratentorial parenchyma of ependymoma preoperative CT and MRI examination of the pathological grading and specific conditions have a certain significance, the clinical surgical treatment has guiding value.