颅内皮样囊肿自发性破裂的CT及MRI表现CT and MRI Manifestations of Spontaneous Ruptured Intracranial Dermoid Cyst
廖欣,詹玮,童娟,于静,蔡立君,高勤
LIAO Xin,ZHAN Wei,TONG Juan,YU Jing,CAI Lijun,GAO Qin
摘要(Abstract):
目的:分析颅内皮样囊肿自发性破裂的CT及MRI表现。方法:9例经手术和病理证实颅内皮样囊肿自发性破裂的CT、MRI资料,分析其病变部位、大小、形态、与脑积液关系、水肿情况等影像学特点。结果:皮样囊肿6例位于幕上,3例位于幕下,4例位于鞍上池,2例位于鞍旁,3例位于桥小脑角区;5例囊肿形态规则,4例形态不规则,边界均清楚;8例周围无水肿,1例周围有轻度水肿,9例病灶均破裂,目脂滴进入脑脊液内;CT扫描2例呈均匀低密度,7例呈不均匀混杂密度,3例病灶内可见钙化;MRI扫描呈不均质混杂信号,其内均可见短T1脂肪信号,破裂的脂滴均呈短T1、长T2信号,脂肪抑制序列短T1信号均可被抑制;增强扫描6例病灶无强化,3例病灶壁呈明显环形强化,2例破裂脂滴邻近脑膜强化,1例室管膜强化。结论:CT及MRI能够准确显示原发部位的皮样囊肿和破裂后游离于脑脊液内的脂滴,表现具有特征性。
Objective: To investigate CT and MRI manifestations of the spontaneous ruptured intracranial dermoid cyst. Methods: Nine patients with spontaneous ruptured intracranial dermoid cyst confirmed by surgical histopathology were analyzed retrospectively,to analyze intracranial dermoid cyst's locations,size,shapes,relationship to cerebrospinal fluid,edema. Results: Six dermoid cyst result presented at the supratentorium,3 located at the infratentorium,4 located at suprasellar cistern,2 in parasellar and 3 in cerebellopontine angle. 5 of these cases presented regular shape and 4 irregular shape,all with clear margin. No edema was found around 8 cases,1 case had mild edema around.The dermoid cyst of 9 cases were ruptured and lipid droplet into the cerebrospinal fluid. CT scan in 2cases showed low density,7 cases showed inhomogeneous density. Calcifications were shown in 3 cases. The tumors revealed inhomogeneous intensity on MRI,signal of short T1 WI could be found in all9 cases. Ruptured lipid droplets all presented T1 WI and T2 WI,and could be suppressed on fat suppressed sequence. After intensified scan,6 cases showed no enhancement,and ring-shaped intense enhancement showed in 3 cases. Additionally,meningeal or ependymal enhancement were found in 3cases. Conclusions: The imaging characteristic of the spontaneous ruptured intracranial dermoid cyst were specific. CT and MR could accurately detect the extent of tumor involvement.
关键词(KeyWords):
皮样囊肿;颅内疾病;体层摄影术,X线计算机;磁共振成像
dermoid cyst;intracranial disease;tomography,X-ray computed;magnetic resonance imaging
基金项目(Foundation): 贵州省卫生厅科学技术基金项目(Gzwkj2013-1-102)
作者(Author):
廖欣,詹玮,童娟,于静,蔡立君,高勤
LIAO Xin,ZHAN Wei,TONG Juan,YU Jing,CAI Lijun,GAO Qin
DOI: 10.19367/j.cnki.1000-2707.2015.10.018
参考文献(References):
- [1]Kabbasch C,Dorn F,Mpotsaris A,et al.Rupture of a spinal dermoid cyst may lead to dissemination and progress of Fatty tissue in the central spinal canal and intracranial subarachnoid space.A case report[J].Neuroradiol J,2014(6):759-763.
- [2]Garg K,Kumar R.Isolated central canal rupture of spinal dermoid.Report of 3 cases[J].J Neurosurg Spine,2014(3):361-366.
- [3]Sharma M,Mally R,Velho V.Ruptured conus medullaris dermoid cyst with fat droplets in the central canal[J].Asian Spine J,2013(1):50-54.
- [4]孟令惠,何杰,崔建岭.中枢神经系统肿瘤破裂脂滴进入脑脊液三例分析及文献复习[J].中华神经医学杂志,2014(6):630-632.
- [5]Esquenazi Y,Kerr K,Bhattacharjee MB,et al.Traumatic rupture of an intracranial dermoid cyst:Case report and literature review[J].Surg Neurol Int,2013(4):80.
- [6]Loumiotis I,Morris JM.Central nervous system epidermoid cyst rupture[J].Arch Neurol,2012(1):136-137.
- [7]Zimny A,Zińska L,Bladowska J,et al.Intracranial lesions with high signal intensity on T1-weighted MR images-review of pathologies[J].Pol J Radiol,2013(4):36-46.
- [8]Asil K,Gunduz Y,Ayhan LT,et al.Spontaneous rupture of intracranial dermoid tumor in a patient with vertigo.Computed tomography and magnetic resonance imaging findings[J].Pol J Radiol,2013(4):79-82.
- [9]Kim KH,Cho JH.Ruptured intracranial dermoid cyst associated with rupture of cerebral aneurysm[J].J Korean Neurosurg Soc,2011(5):453-456.
- [10]Skovrlj B,Mascitelli JR,Steinberger JM,et al.Progressive visual loss following rupture of an intracranial dermoid cyst[J].J Clin Neurosci,2014(1):159-161.
- [11]De Maio PN,Mikulis DJ,Kiehl TR,et al.AIRP best cases in radiologic-pathologic correlation:Spinal conus dermoid cyst with lipid dissemination[J].Radiographics,2012(4):1215-1221.
- [12]文宝红,程敬亮,张勇,等.颅内表皮样囊肿破裂的MRI诊断[J].放射学实践,2013(1):34-37.
文章评论(Comment):
|
||||||||||||||||||
|