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目的探讨乳头状胶质神经元肿瘤(papillaryg lioneuronal tumor,PGNT)的影像学特点及诊断价值。资料与方法结合文献回顾性分析4例PGNT患者的临床、影像和病理学资料,重点分析其发生部位、肿块形态、密度(信号)及病理学特征。结果 4例PGNT均位于大脑半球,其中2例位于颞叶;1例主要位于皮层区,其余3例均累及皮层下白质并邻近侧脑室。肿瘤大小不等,最大径1.1~7.8cm,2例占位效应明显,3例病变周围可见轻度水肿;肿瘤边界清楚,2例呈囊带壁结节样肿块,1例呈实性肿块,1例呈囊性肿块;病变实性部分CT呈稍低密度或等密度,其中1例可见钙化,MRI呈稍长T1、稍长T2信号,其中1例呈长T1、混杂T2信号,DWI呈等信号或稍高信号,增强扫描呈明显强化;病变囊性部分CT呈低密度,MRI呈长T1、长T2信号,DWI呈稍低信号或低信号,增强扫描呈环状强化或无强化;镜下均见特征性假乳头状结构。结论临床表现为头痛或癫痫发作的青年患者,影像学检查发现幕上脑实质内边界清楚的囊实性肿块,尤其是囊带壁结节样肿块,应考虑到PGNT的可能。
Objective To investigate the imaging features and diagnostic value of papillary glioma neuroma (PGNT). Materials and Methods The clinical, imaging and pathological data of 4 patients with PGNT were analyzed retrospectively in literature, with emphasis on their location, mass morphology, density (signal) and pathological features. Results All four PGNTs were located in the hemispheres. Two of them were located in the temporal lobe. One was located in the cortex and the other three involved subcortical white matter and adjacent lateral ventricles. The tumor sizes ranged from 1.1 to 7.8 cm in diameter, with significant mass-bearing effect in 2 cases and slight edema in 3 cases. The borderline of tumor was clear, 2 cases showed cystic nodular mass, 1 mass showed solid mass, One case was cystic mass. CT showed a slightly lower density or isodense density in real part of the lesion. One case showed calcification. MRI showed slightly longer T1 and longer T2 signals. One case showed long T1 and mixed T2 signals And other signals or slightly higher signals, enhanced scan was significantly enhanced; lesion cystic CT was low density, MRI was long T1, T2 signal, DWI was slightly lower signal or low signal enhanced scan showed ring enhancement or no enhancement; Microscopic see the characteristic pseudopapillary structure. CONCLUSIONS: Young patients with clinical manifestations of headache or seizures may have PGNTs taken into account by imaging findings of clear cystic masses within the supratentorial parenchyma, especially of nodular nodular masses.