贵州医科大学学报

2018, v.43;No.214(07) 824-828

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脑内脱髓鞘假瘤的MRI诊断及鉴别诊断
MRI Diagnosis and the Differential Diagnosis of Demyelinating Pseudotumor in the Brain

田斌;罗义琳;宋雯;高勤;余晖;廖欣;
TIAN Bin;LUO Yilin;SONG Wen;GAO Qin;YU Hui;LIAO Xin;Teaching and Research Department of Imaging Diagnosis,Guizhou Medical University;Department of Pathology,The Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:分析脑内脱髓鞘假瘤(DPT)的MRI表现,提高该病的诊断准确率。方法:分析16例脑内DPT的MRI表现,观察DPT部位、形态及影像学特点。结果:16例DPT的MRI表现为单发10例、多发6例,4例边界清楚、12例边界不清,4例形态不规则、2例呈椭圆形,周围伴有不同程度水肿和占位效应;10例呈长T1信号,6例呈等T1信号,16例均呈长T2信号,DWI扩散受限,T2/FLAIR像显示病灶均为高信号;MRI增强扫描后可见病灶强化方式多样,2例未见强化,2例呈结节状强化,3例呈斑片状强化,3例呈弥漫性强化,6例呈环状强化和"开环样强化"。结论:DPT在MRI表现为单发或多发,病灶周围伴有不同程度的水肿和占位效应,以长T_1、长T_2信号为主,增强后可见"开环样强化",这对DPT具有较高的诊断价值。
Objective: To analyze the MRI features of Demyelinating pseudotumor( DPT) in the brain and to improve the diagnostic accuracy of the disease. Methods: The MRI features( lesion location,shape and imaging feature) of 16 cases with DPT in the brain were analyzed. Results: In the 16 cases,10 cases had single DPT in the brain and 6 cases had multiple DPTs in the brain; 4 cases had a clear boundary and 12 cases had unclear boundary; 14 cases were irregular in shape and 2 cases were oval with different degrees of edema and space-occupying effect. 10 cases showed long T1 signal intensity,6 cases showed equal T1 signal intensity,16 cases showed long T2 signal intensity,diffusion weighted imaging( DWI) was limited,and T2/FLAIR showed high signal in the lesions. The enhancement modes of the lesions can be seen in various ways after MRI enhanced scan. 2 cases showed no enhancement,2 cases showed nodular enhancement,3 cases presented patchy enhancement,3 cases demonstrated diffuse enhancement,and 6 cases showed circular and " open-loop " enhancement.Conclusion: DPT showed single or multiple occurrences on MRI with various degrees of edema and space occupying effect around the lesions,mainly with long T1 and long T2 signals and " open-loop enhancement" could be seen after enhancement,which have a high diagnostic value for DPT.

关键词(KeyWords): 脱髓鞘疾病;假瘤;磁共振成像;诊断,鉴别
demyelinating disease;pseudotumor;magnetic resonance imaging;diagnosis,differential

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基金项目(Foundation): 贵州省黔东南州科技计划基金项目[黔东南科合J字(2016)081号]

作者(Author): 田斌;罗义琳;宋雯;高勤;余晖;廖欣;
TIAN Bin;LUO Yilin;SONG Wen;GAO Qin;YU Hui;LIAO Xin;Teaching and Research Department of Imaging Diagnosis,Guizhou Medical University;Department of Pathology,The Affiliated Hospital of Guizhou Medical University;

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