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目的探讨脑室内、外神经细胞瘤的典型及不典型影像表现。方法回顾性分析经手术病理证实的25例中央性神经细胞瘤(CN)和6例脑室外神经细胞瘤(EVN)的临床、影像及病理特征。结果所有病例CT像上均为等密度,MR T_1WI为等或稍低信号,T_2WI为等或稍高信号,FLAIR为稍高信号,DWI为高信号;增强扫描轻度强化25例,明显强化6例。肿瘤多呈圆形或分叶状,边界清,囊变22例(CN 21例,EVN 1例),出血3例(CN 2例,EVN 1例),血管流空18例(CN 17例,EVN 1例),脑积水27例(CN 25例,EVN 2例),瘤周水肿3例(CN 0例,EVN3例),9例CT检查者中钙化6例(CN 5例,EVN 1例)。光镜下,肿瘤细胞呈巢片状的小核细胞,核分裂象少见,30例见神经纤维毡;免疫组织化学:Syn(+)30例,GFAP(-)22例,Neu-N(+)29例,Ki-67检查30例,其中2%以下14例,2%~10%12例,10%以上4例。结论颅内中枢神经细胞瘤具有一定影像特征,但确诊依赖病理及免疫组织化学。
Objective To investigate the typical and atypical manifestations of intracerebral and extra-cellular neuroblastoma. Methods The clinical, imaging and pathological features of 25 cases of central neurocytoma (CN) and 6 cases of extracerebral neuroblastoma (EVN) were retrospectively analyzed. Results The CT images of all cases were isosceles, MR T_1WI was equal or slightly lower signal, T_2WI was equal or slightly higher signal, FLAIR was slightly higher signal and DWI was higher signal. Enhanced scanning was mild enhancement in 25 cases, example. Tumors were mostly round or lobulated with border clearance and cystic change in 22 cases (CN 21 cases and EVN 1 case), bleeding in 3 cases (CN 2 cases and EVN in 1 case), vascular emptying in 18 cases (CN 17 cases, EVN 1), hydrocephalus in 27 cases (CN 25 cases, EVN 2 cases), peritumoral edema in 3 cases (CN 0 cases, EVN 3 cases), calcification in 6 cases (CN 5 cases, EVN 1 example). Under the light microscope, the neoplastic cells were neucleocytic. The mitotic figures were uncommon. The neurofibrils were found in 30 cases. Immunohistochemistry: 30 cases of Syn (+), 22 cases of GFAP (-), Neu- 29 cases, Ki-67 examination of 30 cases, of which 14 cases were less than 2%, 2% to 10% in 12 cases, 10% or more in 4 cases. Conclusion Intracranial neurocytoma has some imaging features, but the diagnosis depends on pathology and immunohistochemistry.