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目的探讨脑室内毛细胞型星形细胞瘤(pilocytic astrocytoma,PA)的MRI特征,旨在提高其术前诊断准确率。方法回顾性总结分析8例脑室内PA患者的MRI特征。8例均行MRI平扫及增强扫描。结果 4例PA位于第四脑室,2例位于侧脑室,2例位于第三脑室。实质型1例,囊实型5例,大囊伴小结节型2例。肿瘤实性部分T1WI呈低信号,T2WI呈高信号,扩散加权成像(DWI)呈低信号,表观扩散系数(ADC)均值(1.5±0.15)×10-3mm2/s,增强扫描病灶明显强化。囊实型囊性部分呈长T1、长T2信号,DWI呈低信号,液体衰减反转恢复序列(FLAIR)呈高信号,大囊伴小结节型囊液呈脑脊液样信号。结论脑室内PA的MRI表现具有一定特征,实性部分T2WI呈高信号、DWI呈低信号且显著强化的脑室内肿瘤术前鉴别诊断时应考虑到该病可能。
Objective To investigate the MRI features of pilocytic astrocytoma (PA) in order to improve the accuracy of preoperative diagnosis. Methods The MRI features of 8 patients with intracerebroventricular PA were retrospectively analyzed. 8 cases underwent MRI plain scan and enhanced scan. Results Four cases of PA located in the fourth ventricle, two in the lateral ventricle and two in the third ventricle. 1 case of parenchyma, 5 cases of parenchyma and 2 cases of pouch with nodules. Tumor solid part of the T1WI showed low signal, T2WI showed high signal, diffusion weighted imaging (DWI) showed low signal, apparent diffusion coefficient (ADC) mean (1.5 ± 0.15) × 10-3mm2 / s, enhanced enhanced scan lesions significantly enhanced. The cystic solid cystic part of the long T1, long T2 signal, DWI was low signal, fluid attenuation inversion recovery sequence (FLAIR) was high signal, cystic small nodular cyst was CSF signal. Conclusions The MRI findings of intracerebroventricular (PA) have certain characteristics. The T2WI in solid part shows high signal, and the low signal of DWI and the marked enhancement of intracerebroventricular tumor should be considered in the preoperative diagnosis.