MRI and clinical diagnosis of central neurocytoma
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摘要: 目的 探讨中枢神经细胞瘤(central neurocytoma,CNC)的MRI及临床特点,以提高对该病的认识。 方法 回顾性分析2011—2016年滁州市第一人民医院6例经手术病理证实的CNC的MRI表现,6例均行MRI平扫及增强扫描。 结果 6例肿瘤5例位于侧脑室孟氏孔附近,1例位于左侧侧脑室三角区。男性2例,女性4例,年龄范围16~38岁,平均年龄25岁,肿瘤宽基底与透明隔相连,呈类圆形或不规则肿块,5例呈囊实性混合性病灶,1例肿瘤呈实体性,均伴有不同程度的脑积水,有1例病灶侵犯邻近脑实质,1例肿瘤向第三脑室内生长,较大病灶均可见囊变,并见等信号条索状结构与侧脑室壁、透明隔、胼胝体相连或粘连,较小病灶没有囊变,部分病灶内可见迂曲血管影,所有病灶均未见出血,T1WI呈等低信号,T2WI呈等高信号,DWI呈等高信号,部分病灶内信号不均,呈蜂窝状,增强扫描肿瘤实质有轻度到明显强化。病理切片显示,CNC由形态一致的小细胞组成,胞核圆形居中,包浆透明,可见特征性的由纤维基质组成的无细胞带及“假菊花团”征象。免疫组化染色提示本组6例突触素(Syn)均呈阳性结果。 结论 脑室内CNC有特征性“周边囊肿-条索征”“血管匍行征”表现,结合DWI信号特点,有助于提高中枢神经细胞瘤的术前诊断准确性及协助临床治疗方案的制订。Abstract: Objective to investigate the MRI features of the central neurocytoma and its clinical characteristics, in order to improve the understanding of the disease. Methods MR imaging of 6 patients with central neurocytoma confirmed surgically and pathologically were retrospectively reviewed. Conventional plain and enhance MR scan were performed in all patients. Results The tumors in 5 cases located in the lateral ventricle monro, 1 case was located in the left lateral ventricle triangle, including 2 males and 4 females, aged from 16 to 38 years old, with an average age of 25. Tumors were connected to the septum pellucidum with wide base, a kind of round or irregular mass. Five cases were presented as cystic or solid mixed lesions, tumor of 1 case was solid, associated with different degree of hydrocephalus, 1 case of lesion invasion, adjacent brain parenchyma. There were 1 cases of invasion of adjacent brain parenchyma, and the growth of the tumor in 1 cases in the third ventricle. Cystic changes could be seen in larger lesions, but in smaller lesions, as well as there were multiple stripe-like structures in the periphery, which adhered to the ventricle walls, septum pellucidum and callus. Circuity blood vessels were found in partial lesions. All lesions were not seen bleeding, presented as equal or isointensity signal on T1WI, hyperintensity or equal signal on T2WI and DWI, and the internal signal of some tumors was inhomogeneous and honeycomb, mild to marked enhancement. Pathology showed, CNC in tumor tissue cell morphplpgy, centered round nucleus, transparent cytoplasm, was made up of characteristic fiber matrix cell free belt and "fake chrysanthemum group "signs. Immunohistochemical study suggests the 6 cases of synaptic element (Syn) are positive results. Conclusion Intraventricular CNC had characteristics of "peripheral cyst-spicules sign"and "snake-like flow void sign", combined with DWI signal characteristics can help improving central nervous cell tumor of the preoperative diagnostic accuracy and clinical treatment.
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