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tqscspbuhct
Posted: Thu 13:04, 10 Mar 2011
Post subject: 中枢神经细
中枢神经细胞瘤CT、MRI对比分析及鉴别诊断
管流空信号及肿瘤浸润范围优于CT,文献认为TwI像多发小囊变是CNC的一个有特点征象口],本组资料显示MRI对判断肿瘤囊变、大小、数目、形态强于CT,并且2例肿瘤内部可见血管流空信号更有助于诊断,文献报道CNC囊变及血管流空征象有助于CNC诊断],所以CT、MRI优势互补更有利于CNC诊断。文献报道CNC出血少见,本组仅有1例肿瘤出血。本组资料CT和MRI均无瘤周水肿及侵袭脑实质的征象,有助于与室管膜瘤相鉴别。肿瘤边界不规则,多有分叶,分析原因肿瘤偏良性,生长缓慢,与脑室壁或透明隔长期接触,粘连及肿瘤生物学特性所致。增强检查多呈中度一明显强化影。本组5例均有不同程度的侧脑室扩张。鉴别诊断:CNC的CT、MRI影像学表现虽然具有一些特征,但还需以下列肿瘤鉴别。室管膜瘤好发于侧脑室三角区,可沿脑室壁塑型生长,也可向脑室外生长。室管膜下巨星形细胞瘤多伴室管膜下结节硬化,临床上多有典型“三联症”癫痫、智力低下、面部皮脂腺瘤。室管膜下瘤肿瘤伴囊变少,增强后不强化或轻微强化易于鉴别。脉络丛乳头状瘤儿童最常见在侧脑室三角区,成人最常见为第四脑室,肿瘤多呈分叶状或菜花状,增强明显强化,常伴交通性脑积水。脑膜瘤多见中年妇女,好发侧脑室三角区,肿瘤密度、信号均匀,呈明显均匀强化,易鉴别。中枢神经细胞瘤是一种少见肿瘤,其发病年龄、部位及CT、MRI具有一定特点,CT可明确肿瘤部位,显示钙化佳,MRI更好的了解肿瘤起源、范围、对瘤内囊变、坏死、流空信号优于CT,对于青年人发生于侧脑室体前部、透明隔肿瘤,依据年龄、临床病史及CT、MRI影像特点,多能够做出正确诊断。
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