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目的探讨小脑延髓池肿瘤的MRI诊断价值。方法对17例经手术病理证实的小脑延髓池肿瘤的MRI表现进行回顾性分析。所有病例均采用3.0 T MR扫描仪平扫加增强扫描,并行横断位、矢状位、冠状位重组,分析肿瘤部位、与周围组织的关系及MRI特征。结果本组中神经鞘瘤4例,肿瘤贴附于延髓背侧呈偏侧性生长,囊变明显,增强囊壁及实性部分明显强化;室管膜瘤3例,肿瘤定位于小脑延髓池,形态不规则并有囊变,可见脑脊液环绕,增强实性部分轻至中度强化;脑膜瘤3例,均为宽基底的实性肿块,增强均匀明显强化,其中1例见“脑膜尾征”;血管母细胞瘤3例,2例表现为“大囊小结节”;1例瘤体为实性肿块,增强后明显强化,瘤周可见粗大供血动脉;脉络丛乳头状瘤2例,为小脑延髓池内浅分叶状的肿块,周围见脑脊液环绕,信号稍不均匀,增强均见明显强化,1例见微囊变;胶质母细胞瘤1例,肿瘤来源于小脑半球并突向小脑延髓池,信号不均匀,见多发囊变及周围脑组织水肿,增强后呈“花环”状强化;脂肪瘤1例,T1WI、T2WI均呈高信号,脂肪抑制呈低信号,边界清晰,增强扫描强化不明显。结论小脑延髓池肿瘤的MRI表现各有其特点,通过MRI检查能精确定位,有助于推断肿瘤的来源,并根据信号特点进行定性诊断。
Objective To investigate the MRI diagnostic value of cerebellar cistern tumor. Methods The MRI findings of 17 cases of cerebellomedullary cistern tumors confirmed by surgery and pathology were retrospectively analyzed. All cases were scanned by 3.0 T MR scan and enhanced scan, and the transverse, sagittal and coronal planes were reorganized to analyze the relationship between tumor location and surrounding tissues and MRI features. Results 4 cases of schwannoma in this group, the tumor attached to the dorsal medulla oblongata was lateral growth, cystic degeneration significantly enhanced cyst wall and solid parts were significantly enhanced; ependymoma in 3 cases, the tumor located in the cerebellar cistern , Irregular shape and cystic change, we can see the cerebrospinal fluid around, and enhance the solid part of the light to moderate enhancement; 3 cases of meningioma, are wide base of solid mass, enhanced significantly enhanced significantly, including 1 case of “ 3 cases of hemangioblastoma, 2 cases showed ”small cystic nodules “; 1 case of tumor was solid mass, enhanced significantly enhanced, the tumor can be seen thick feeding artery; choroid plexus papillary 2 cases of tumor, shallow lobulated mass in the cisternia cerebellum, surrounded by cerebrospinal fluid, the signal is slightly uneven, enhanced were significantly enhanced, 1 case of microencapsulated; glioblastoma in 1 case, the tumor originated from the cerebellum Hemisphere and protruding cerebellar cistern, the signal is not uniform, see multiple cystic changes and surrounding brain tissue edema, increased after the ”rosette" -like enhancement; lipoma in 1 case, T1WI, T2WI showed high signal, fat was low Signal, clear boundary, enhanced scan enhancement is not obvious. Conclusions MRI findings of cerebellar cistern tumors have their own characteristics. Accurate localization by MRI can help infer the origin of the tumor and make qualitative diagnosis based on the characteristics of the signal.