| 张婧,周俊林,董驰.不同分级颅内血管外皮细胞瘤的影像学表现与病理对照[J].中国医学影像技术,2012,28(5):861~864 |
| 不同分级颅内血管外皮细胞瘤的影像学表现与病理对照 |
| Comparison of imaging and pathological findings of different grade intracranial hemangiopericytoma |
| 投稿时间：2011-11-13 修订日期：2011-12-06 |
| DOI： |
| 中文关键词: 血管外皮细胞瘤 磁共振成像 病理学 |
| 英文关键词:Hemangiopericytoma Magnetic resonance imaging Pathology |
| 基金项目:甘肃省兰州市科技计划资助项目(07-1-84)。 |
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| 中文摘要: |
| 目的 对比分析不同分级颅内血管外皮细胞瘤(HPC)的影像学特征。 方法 回顾性分析经手术病理证实不同分级HPC 39例,均接受MR平扫及增强扫描,并与病理表现进行对照。 结果 39例患者中,WHO Ⅲ级间变型HPC 21例,WHO Ⅱ级HPC 18例,均位于颅内脑外。21例间变型HPC中,20例病灶呈分叶状或不规则形,9例跨叶生长;MR平扫T1WI呈等、高、低混杂信号20例,等信号1例;T2WI呈高、低混杂信号20例,等信号1例;增强扫描呈不均匀显著强化19例;明显囊变坏死16例,“硬膜尾征”2例,相邻颅骨破坏10例,瘤周水肿明显16例。18例HPC中,病灶呈类圆形9例,跨叶生长3例;MR平扫T1WI呈等、低混杂信号10例,等信号8例;T2WI呈等、高混杂信号10例,等信号8例;增强扫描呈均匀显著强化10例;明显坏死囊变7例,“硬膜尾征”6例,相邻颅骨破坏2例,所有病灶瘤周水肿不明显。病理示间变型HPC Ki-67阳性细胞数平均(18.41±1.31)%,HPC Ki-67阳性细胞数平均(7.12±0.78)%。 结论 颅内间变型HPC与HPC影像学表现有所差异,前者具有更明显的分叶状、跨叶生长倾向,肿瘤更易出血、坏死、囊变致信号不均匀,少见“硬膜尾征”,更易破坏邻近颅骨,瘤周水肿明显等特点,可与后者鉴别。 |
| 英文摘要: |
| Objective To analyze and compare imaging features with pathological findings of different grade intracranial hemangiopericytoma (HPC). Methods Thirty-nine patients of different grade HPC proved with operation and pathology were analyzed retrospectively. Both plain and enhanced MR scans were performed, and the results were compared with pathology. Results In 39 cases, WHO Ⅲ grade anaplastic HPC were found in 21 cases and WHO Ⅱ grade HPC in 18 cases. All the intracranial tumors located outside the brain. Twenty cases were lobulated and 9 growed cross-leaf in 21 anaplastic HPC. On MRI, the lesions showed mixed iso-high-low signal (n=20) or iso-signal (n=1) on plain T1WI, while mixed high-low signal (n=20) or iso-signal (n=1) on plain T2WI. After contrast injection, heterogeneous enhancement was seen in 19 cases. Significant necrosis and cyst were seen in 16 cases, while "dural tail sign" in 2 cases. Ten cases appeared bony destruction and 16 cases showed significant peritumoral edema. Lesions showed oval in 9 patients and growed cross-leaf in 3 of 18 WHO Ⅱ grade HPC. On MRI, the lesions showed mixed iso-low signal (n=10) or iso-signal (n=8) on plain T1WI, while mixed iso-high signal (n=10) or iso-signal (n=8) on plain T2WI. After contrast injection, significantly enhanced uniform was seen in 10 cases. Significant necrosis and cyst were seen in 7 cases, "dural tail sign" in 6 cases and 2 cases appeared bony destruction. No significant peritumoral edema was detected. Pathology showed an average of (18.41±1.31)% Ki-67 positive cells in anaplastic HPC, while of (7.12±0.78)% in WHO Ⅱ grade HPC. Conclusion Imaging findings of intracranial anaplastic HPC and WHO Ⅱ grade HPC are different, the former has more pronounced lobulated, cross-leaf growth tendency, easily bleeding, necrosis, cystic to heterogeneous signal, rare "dural tail sign", more damage near the skull, significant peritumoral edema, etc.that are helpful to the differential diagnosis. |
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