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目的分析不同种类小脑囊性肿瘤性病变的MRI表现特点,探讨发生于小脑的囊性肿瘤性病变的MRI表现规律,以提高诊断水平。方法回顾性分析2010年8月至2016年2月安徽医科大学第一附属医院经手术病理证实的23例小脑肿瘤患者的影像学资料,分析评价病变的囊变程度、部位、大小、边界、周围水肿、占位效应、梗阻性脑积水的情况。探讨不同种类小脑囊性肿瘤性病变的MRI影像学表现特点及规律。结果发生于小脑的囊性病变23例,其中髓母细胞瘤12例(52%),血管母细胞瘤8例(35%),毛细胞型星形细胞瘤3例(13%)。髓母细胞瘤有囊变者8例,但范围均较小,血管母细胞瘤8例均表现为大囊小结节,毛细胞型星形细胞瘤3例囊变范围均较大,结节较血管母细胞瘤结节大;3种肿瘤边界清晰、周围无或仅I度水肿、占位效应较轻、肿瘤体积较大时易引起梗阻性脑积水,增强扫描髓母细胞瘤囊性部分不强化、实性部分中至重度强化,血管母细胞瘤与毛细胞型星形细胞瘤囊变部分不强化,结节重度强化,血管母细胞瘤囊壁无强化,2例毛细胞型星形细胞瘤囊壁可见强化。结论 MRI图像可以清楚的显示肿瘤位置、囊变程度及占位效应等,具有重要的诊断价值。髓母细胞瘤小脑蚓部多见,囊变多见,但囊变范围较小,占位效应较轻;血管母细胞瘤和毛细胞型星形细胞瘤小脑半球多见,囊变多见,囊变范围较大;血管母细胞瘤有典型的大囊小结节MRI表现,囊壁强化少见,毛细胞型星形细胞瘤有典型的大囊大结节表现,囊壁强化多见。
Objective To analyze the MRI manifestations of different types of cerebellar cystic neoplastic lesions and to explore the MRI manifestations of cystic neoplastic lesions in the cerebellum in order to improve the diagnostic level. Methods We retrospectively analyzed the imaging data of 23 patients with cerebellar neoplasms confirmed by surgery and pathology from the First Affiliated Hospital of Anhui Medical University from August 2010 to February 2016 and evaluated the degree of cystic degeneration, location, size, boundary and surrounding Edema, mass effect, obstructive hydrocephalus. To explore the different types of cerebellar cystic neoplasms MRI features and characteristics of the law. The results occurred in cerebellar cystic lesions in 23 cases, of which 12 cases of medulloblastoma (52%), 8 cases of hemangioblastoma (35%), hairy astrocytoma in 3 cases (13%). Myeloblastoma cystic change in 8 cases, but the range is small, 8 cases of hemangioblastoma showed large nodules, hairy astrocytoma 3 cases of cystic deformity were larger nodules More than the nodules of hemangioblastoma; clear boundary of the three tumors, no or only I degree of edema around the placeholder effect lighter, easy to cause obstructive hydrocephalus when the tumor volume is larger, enhanced scan medulloblast cyst Some not to strengthen the solid part to moderately intensive, hemangioblastoma and hair follicle astrocytoma cystic part does not strengthen, severe nodular enhancement, no enhancement of hemangioblastoma wall, 2 cases of hair cell type star Astrocytoma can be seen enhanced wall. Conclusion MRI images can clearly show the tumor location, degree of cystic lesions and space-occupying effect, which has important diagnostic value. Mepoblastoma cerebellar vermis more common, cystic degeneration more common, but a smaller range of cystic change, placeholder effect lighter; hemangioblastoma and hairy cell type astrocytoma more common cerebellar hemisphere, cystic degeneration more common, Large range of cystic degeneration; hemangioblastoma typical small nodular MRI performance, enhanced rare cystic wall, hairy astrocytoma typical large nodules, wall enhancement more common.