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目的探讨中枢神经细胞瘤(central neurocytoma,CNC)的MRI及临床特点,以提高对该病的认识。方法回顾性分析2011—2016年滁州市第一人民医院6例经手术病理证实的CNC的MRI表现,6例均行MRI平扫及增强扫描。结果 6例肿瘤5例位于侧脑室孟氏孔附近,1例位于左侧侧脑室三角区。男性2例,女性4例,年龄范围16~38岁,平均年龄25岁,肿瘤宽基底与透明隔相连,呈类圆形或不规则肿块,5例呈囊实性混合性病灶,1例肿瘤呈实体性,均伴有不同程度的脑积水,有1例病灶侵犯邻近脑实质,1例肿瘤向第三脑室内生长,较大病灶均可见囊变,并见等信号条索状结构与侧脑室壁、透明隔、胼胝体相连或粘连,较小病灶没有囊变,部分病灶内可见迂曲血管影,所有病灶均未见出血,T_1WI呈等低信号,T_2WI呈等高信号,DWI呈等高信号,部分病灶内信号不均,呈蜂窝状,增强扫描肿瘤实质有轻度到明显强化。病理切片显示,CNC由形态一致的小细胞组成,胞核圆形居中,包浆透明,可见特征性的由纤维基质组成的无细胞带及“假菊花团”征象。免疫组化染色提示本组6例突触素(Syn)均呈阳性结果。结论脑室内CNC有特征性“周边囊肿-条索征”“血管匍行征”表现,结合DWI信号特点,有助于提高中枢神经细胞瘤的术前诊断准确性及协助临床治疗方案的制订。
Objective To investigate the MRI and clinical features of central neurocytoma (CNC) to improve the understanding of the disease. Methods The MRI findings of 6 cases confirmed by surgery and pathology in the First People’s Hospital of Chuzhou from 2011 to 2016 were retrospectively analyzed. All 6 cases underwent MRI plain scan and enhanced scan. Results Five of the six tumors were located near the Monteggia hole in the lateral ventricle and one in the trigone of the left lateral ventricle. 2 males and 4 females, aged from 16 to 38 years old with a mean age of 25 years. The wide base of the tumor was connected with the clear septum with a round or irregular mass. Five patients had cystic solid mixed lesions and one tumor Was solid, are associated with varying degrees of hydrocephalus, 1 case of lesions invade the adjacent brain parenchyma, 1 case of tumor growth to the third ventricle, larger lesions can be seen cystic change, and see the signal cable structure and other Lateral ventricular wall, transparent septum, corpus callosum or adhesion, smaller lesions did not cystic change, some lesions showed tortuous blood vessels shadow, all lesions were no bleeding, T_1WI showed low signal, T_2WI was contour, DWI was contour Signal, partial lesions within the signal uneven, honeycomb, enhanced scan of the tumor with mild to significant enhancement. Pathological examination showed that the CNC consisted of small cells in the same shape. The nucleus was round and the plasma was transparent. The characteristic cytoplasm of the fibrous matrix and the signs of “false chrysanthemum” were observed. Immunohistochemical staining prompted the group of 6 cases of synaptophysin (Syn) were positive results. Conclusion The intracranial CNC has the characteristic features of “peripheral cyst-stripe sign” and “vascular creeping sign”, combined with the characteristics of DWI signal, which can help to improve the accuracy of preoperative diagnosis of central neurocytoma and assist clinical treatment Program development.