CAJ | 학술논문

目的：探讨颅内血管外皮细胞瘤（hemangiopericytoma ，HPC）的影像特征。方法回顾性分析经病理及免疫组织化学证实的16例 HPC患者的CT及MRI表现。所有患者均行MR扫描，6例行CT扫描。结果所有病变均为单发病灶，均位于颅内脑外，均为分叶状肿块，15例位于幕上，1例位于幕下。6例C T 平扫均呈稍高密度、间杂低密度，均未见钙化，1例邻近颅底骨质呈侵蚀破坏，5例增强扫描均呈明显不均匀强化，并可见明显增粗的血管影，4例可见明显的瘤周水肿带。T1 WI以等、低信号、T2 WI以低、高混杂信号为主，2例信号均匀、14例信号不均，13例周围有水肿。增强扫描中15例病灶均明显不均匀强化，1例中度强化。2例病灶与硬膜呈宽基底相连，14例为窄基底相连。16例病灶均未出现“脑膜尾征”。DWI中，7例肿瘤呈等低混杂信号为主。MRS中，4例Cho峰明显升高；2例NAA峰及Cr峰降低。结论 H PC影像表现具有一定特点，当脑外肿瘤呈分叶状，内部密度不均匀，有囊变坏死，周围骨质无增生硬化，甚至有破坏吸收改变，水肿较严重，肿瘤内未见钙化，侵犯周围脑组织或并发颅外转移时，提示H PC可能性大。
목적：탐토로내혈관외피세포류（hemangiopericytoma ，HPC）적영상특정。방법회고성분석경병리급면역조직화학증실적16례 HPC환자적CT급MRI표현。소유환자균행MR소묘，6례행CT소묘。결과소유병변균위단발병조，균위우로내뇌외，균위분협상종괴，15례위우막상，1례위우막하。6례C T 평소균정초고밀도、간잡저밀도，균미견개화，1례린근로저골질정침식파배，5례증강소묘균정명현불균균강화，병가견명현증조적혈관영，4례가견명현적류주수종대。T1 WI이등、저신호、T2 WI이저、고혼잡신호위주，2례신호균균、14례신호불균，13례주위유수종。증강소묘중15례병조균명현불균균강화，1례중도강화。2례병조여경막정관기저상련，14례위착기저상련。16례병조균미출현“뇌막미정”。DWI중，7례종류정등저혼잡신호위주。MRS중，4례Cho봉명현승고；2례NAA봉급Cr봉강저。결론 H PC영상표현구유일정특점，당뇌외종류정분협상，내부밀도불균균，유낭변배사，주위골질무증생경화，심지유파배흡수개변，수종교엄중，종류내미견개화，침범주위뇌조직혹병발로외전이시，제시H PC가능성대。
Objective To summarize the imaging features of hemangiopericytoma (HPC) .Methods 16 patients with HPC proven histopathologically were collected .6 cases had CT data and all cases had MR data ,The imaging features and pathological results were retrospectively analyzed .Results All cases were single lesions with lobulated shape ,arose out-side the brain .15 cases (15/16) were supratentorial while 1 case was infratentorial .6 cases with plain scan were manifes-ted as high and low isodensity ,and none had calcification .Smooth erosion of the basicranial skull in 1 lesion .5 cases were obvious heterogeneous enhancement ,and marked enlarged vascular image could be seen .There was obvious perilesional e-dema in 4 cases .There were low signal or equisignal on T1WI ,while T2WI showed high and low signal .The signals of the 2 cases were homogenous ,however ,the signals of the other 14 cases were heterogeneous .In 13 cases ,around the lesions were edema belt .15 cases were obvious inhomogeneous enhancement in CT enhancement scanning .1 case was moderate enhancement .2 tumors were broad-based dural attachment .14 tumors were narrow -based dural attachment .There was no "dural tail sign"in all 16 cases .Most of signals in 7 cases were mixed with low and iso-intensity by DWI .The peaks of cho in 4 cases were significantly increased in MRS ,while the Peaks of NAA and Cr in 2 cases were decreased .Conclusion Image performance of HPC embodies certain characteristics .The features make the HPC possibility more likely ,such as lobulated in shape of the tumors ,inhomogeneous in density ,cyst degeneration or necrosis ,having no hyperplasia and scle-rosis of surrounding bone ,having a change of damage absorption ,having no calcifications ,having some edema ,and inva-ding the surrounding brain or having extracranial metastases .