- 期刊
- OpenAccess
Magnetic Resonance Images of Hemangioblastomas in the Central Nervous System
中樞神經系統血管母細胞瘤的磁振造影
摘要
本研究報告主要在探討8名患者經手術證實之18個中樞神經系統血管母細胞瘤，有關其MR影像中各種表現之臨床意義。其中為3名男性及5名女性患者，年齡為26至57歲；採用0.ST超導型MR掃描儀檢查。18個病變中有15、2及1個腫瘤分別位於小腦半球、延腦及上頸髓等3處。病變共可歸納成下列5種類型：一大囊腫中含有一細小壁結節、一大囊腫中含有多個細小壁結節、單一固態腫瘤、含有小型周邊囊腫之固態腫瘤、含有周邊及中心囊腫之固態腫瘤。腫瘤之囊腫部分在T1WI中呈現低信號強度，在PDWI與T2WI中呈現高信號強度；其固態部分在T1WI中呈現比小腦皮質稍低或相等的信號強度，在PDWI與T2WI中呈現極高信號強度，而在注射Gd-DTPA增強對比的T1WI中呈現顯著之增強影像。有2名患者在MR影像中發現上頸部之脊髓空洞症。其中發生延腦病變之患者在MR檢查前之CT像中無法認出病變之存在。MR影像除了能呈現優良之對比效果及多方向顯像功能之外，其不產生骨骼假影之特點，對評估主要發生在後顱窩之血管母細胞瘤更有意義。由於在手術中必須將大囊腫型病變之細小壁結節完全切除，患者才會痊癒，因此不但所有這類患者都應該在術前採用MR詳細評估，更必須重視經靜脈注射Gd-DTPA增強對比的重要性。
並列摘要
Detailed findings on magnetic resonance (MR) images of 18 histologically proven hemangioblastomas of the central nervous system in 8 patients are reported here. Five morphological types of the tumors were identified a small mural nodule in a large cyst; multiple mural nodules in a large cyst; a solid tumor; a solid tumor with a small peripheral cyst and a solid tumor with internal and peripheral cysts. There were fifteen tumors found located at the cerebellar hemispheres, two found at the medulla and one found at the upper cervical cord. Upper cervical syringes were found in two cases. Four patients had multiple tumors, and two of them were patients with von Hippel-Lindau disease. The cystic portions were generally hypointense on T1-weighted image (T1WI) and hyperintense on T2-weighted image (T2WI) and proton-density-weighted image (PDWI). The solid portions were slightly hypointense or isointense in contrast to adjacent brain structures on T1WI but marked hyperintense on T2WI and PDWI. Intense homogeneous enhancement of all solid portions was seen after intravenous administration of gadolinium-DTPA (Gd-DTPA). It is of paramount importance to recognize and remove the fine mural nodule in the cystic part of hemangioblastoma in order to prevent recurrence. Thus, magnetic resonance imaging (MRI) with intravenous Gd-DTPA enhancement should be performed for complete evaluation of all cases of hemangioblastomas of the central nervous system prior to surgical intervention.
延伸閱讀
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