CAJ | 학술논문

目的：探讨儿童毛细胞黏液样星形细胞瘤（ PMA ）的MRI表现。方法回顾性分析2011年至2013年间经手术病理证实的7例PMA的MRI表现。男3例、女4例；年龄10～32个月，中位年龄21个月。结果肿瘤病灶边界清楚，6例位于下丘脑-视交叉-第三脑室区域，2例累及双侧颞叶，1例合并神经纤维瘤病-Ⅰ型（ NF-Ⅰ）；1例位于基底节区。实性肿块4例，实性伴囊变3例。T1 WI中，液体衰减反转恢复序列（ FLAIR）检查6例，5例呈低信号，1例呈等信号；FSE序列1例，呈低信号。 T2 WI中，FLAIR序列检查3例，1例呈高信号，2例呈等信号；FSE序列5例，4例呈高信号，1例呈等信号。 DWI 6例，4例呈低信号，1例呈等信号，1例呈等低信号。增强后明显强化，4例均匀强化，3例不均匀强化，1例边缘强化，2例瘤内见不规则低信号区。2例脑脊液播散，1例瘤周轻度水肿，4例脑积水。 MRS检查2例，胆碱（Cho）/肌酸（Cr）升高，N-乙酰天冬氨酶（NAA）/Cr降低。结论PMA的MRI表现具有特征性，好发于3岁以下婴幼儿；下丘脑-视交叉-第三脑室区常见，强化方式多样，肿瘤内出血和周围水肿少见，脑脊液播散较常见。
목적：탐토인동모세포점액양성형세포류（ PMA ）적MRI표현。방법회고성분석2011년지2013년간경수술병리증실적7례PMA적MRI표현。남3례、녀4례；년령10～32개월，중위년령21개월。결과종류병조변계청초，6례위우하구뇌-시교차-제삼뇌실구역，2례루급쌍측섭협，1례합병신경섬유류병-Ⅰ형（ NF-Ⅰ）；1례위우기저절구。실성종괴4례，실성반낭변3례。T1 WI중，액체쇠감반전회복서렬（ FLAIR）검사6례，5례정저신호，1례정등신호；FSE서렬1례，정저신호。 T2 WI중，FLAIR서렬검사3례，1례정고신호，2례정등신호；FSE서렬5례，4례정고신호，1례정등신호。 DWI 6례，4례정저신호，1례정등신호，1례정등저신호。증강후명현강화，4례균균강화，3례불균균강화，1례변연강화，2례류내견불규칙저신호구。2례뇌척액파산，1례류주경도수종，4례뇌적수。 MRS검사2례，담감（Cho）/기산（Cr）승고，N-을선천동안매（NAA）/Cr강저。결론PMA적MRI표현구유특정성，호발우3세이하영유인；하구뇌-시교차-제삼뇌실구상견，강화방식다양，종류내출혈화주위수종소견，뇌척액파산교상견。
Objective To investigate the MRI features of pilomyxoid astrocytoma ( PMA ) in children.Methods MRI features of seven children with pathologically proven PMA in 2011-2013 were retrospectively analyzed.The ages of the patients ranged from 10 months to 32 months at initial diagnosis.Results All tumors were well-circumscribed masses.Six tumors were located in the hypothalamic-chiasmatic-third ventricular region , two tumor involved the bilateral temporal lobe , and one tumor was associated with NF-I.One occurred in the basal ganglia region.Four tumors were solid masses , whereas the other three showed cystic components.Six tumors were hypointense and one was isointense on T 1-weighted image.Five tumors were hyperintense and three were isointense on T 2-weighted image.Four tumors were hypointense , one was iso-hypointense and one was isointense on DWI.After contrast administration , four tumors enhanced homogenously and three tumors enhanced heterogeneously , with intratumoral irregular hypointense region in two tumors and rim enhancement in one tumor.Cerebrospinal fluid ( CSF ) dissemination, hydrocephalus and peritumor edema were observed in 2, 4 and 1 of cases, respectively.Proton magnetic resonance spectrum of two PMA showed elevated Cho /Cr ratios and decreased NAA/Cr ratios.Conclusions The imaging features of pilomyxoid astrocytoma include common origination from the midline of the neuroaxis in younger children about 2-3 years old.The CSF dissemination is common.The presence of hemorrhage and peritumor edema is not common.