CAJ | 학술논문

目的：探讨颅内血管周细胞瘤（H PC ）的影像学特征，以提高对该病的诊断水平。方法回顾性分析经手术病理证实的26例颅内H PC的影像学及病理资料。结果26例患者中，所有病灶位于颅内脑外，位于颅底7例、矢状窦旁5例、大脑镰旁4例、小脑幕旁3例、大脑凸面7例。病灶呈分叶状15例，呈不规则形11例。C T平扫呈等密度或稍高密度7例，稍低密度3例；颅骨破坏4例，瘤内钙化1例；增强扫描病灶呈均匀明显强化4例，不均匀强化6例。MR平扫病灶T1 WI呈等、高、低混杂信号20例，稍低信号3例，稍高信号3例；T2 WI呈高、低混杂信号18例，等、低混杂信号5例，等信号3例；T1 WI及T2 WI显示坏死囊变21例；有血管流空18例，出血7例，4例肿瘤邻近颅骨破坏；增强扫描22例呈不均匀显著强化，4例呈均匀显著强化，17例瘤周水肿明显。镜检示瘤细胞弥漫分布，间质有大量裂隙状血管；免疫组化结果显示26例Vim、CD34、CD99阳性，CD31、EMA、CK、Syn及Bcl-2均阴性。结论 HPC的影像学表现具有一定特征性，但需与脑膜瘤鉴别，要注意分析其恶性征象，以提高术前诊断的正确率。
목적：탐토로내혈관주세포류（H PC ）적영상학특정，이제고대해병적진단수평。방법회고성분석경수술병리증실적26례로내H PC적영상학급병리자료。결과26례환자중，소유병조위우로내뇌외，위우로저7례、시상두방5례、대뇌렴방4례、소뇌막방3례、대뇌철면7례。병조정분협상15례，정불규칙형11례。C T평소정등밀도혹초고밀도7례，초저밀도3례；로골파배4례，류내개화1례；증강소묘병조정균균명현강화4례，불균균강화6례。MR평소병조T1 WI정등、고、저혼잡신호20례，초저신호3례，초고신호3례；T2 WI정고、저혼잡신호18례，등、저혼잡신호5례，등신호3례；T1 WI급T2 WI현시배사낭변21례；유혈관류공18례，출혈7례，4례종류린근로골파배；증강소묘22례정불균균현저강화，4례정균균현저강화，17례류주수종명현。경검시류세포미만분포，간질유대량렬극상혈관；면역조화결과현시26례Vim、CD34、CD99양성，CD31、EMA、CK、Syn급Bcl-2균음성。결론 HPC적영상학표현구유일정특정성，단수여뇌막류감별，요주의분석기악성정상，이제고술전진단적정학솔。
Objective To explore the imaging features of intracranial hemangiopericytoma (HPC) and to improve the di-agnosis of the disease .Methods The imaging appearances and pathological data of 26 cases of intracranial HPC proved by pathology and operation were analyzed retrospectively .Results All the intracranial tumors of 26 patients were located in-side the skull and outside the brain parenchyma ,including that 7 tumors were located in the skull base ,5 in sagittal sinus surface ,4 in cerebral falx ,3 in tentorium cerebelli and 7 in brain convexity .15 tumors had lobulated appearance and 11 tumors were irregular shape .On CT ,the tumors were manifested as isodensity or slightly high density (n=7) and slightly hypodense (n=3) .4 cases showed bony destruction ,1 case had calcification .After contrast injection ,homogeneous en-hancement was seen in 4 cases and inhomogeneous enhancement in 6 cases .On MRI ,the lesions were shown heterogeneity (n=20) or slightly hypointense (n=3) or slightly hyperintense (n=3)on T1 WI ,mixed high-low signal (n=18) or iso-low signal (n=5) or iso-signal (n=3) on T2 WI .cystic degeneration (n=21) ,blood vessel flow void phenomenon (n=18) ,hemorrhage (n=7) and bony destruction (n=4) were shown on both T1 WI and T2 WI .After contrast injection ,in-homogeneous enhancement was seen in 22 cases and uniform enhancement in 4 cases .17 cases showed significant peritu-moral edema .Pathology showed tumor cells were diffusely distributed .The stroma had large number of slit-like vascula-ture .Immunohistochemical examination showed CD34 ,vimentin and CD99 expression ,and CD31 ,epithelial membrane antigen ,cytokeratin ,synaptophysin and Bcl-2 showed no expression in all 26 cases .Conclusion The imaging findings of HPC have certain characteristics ,which are helpful for suggesting the diagnosis .It should be differentiated with meningio-ma .Some malignant appearance should be observed carefully in order to improve the correct diagnostic rate .