CAJ | 학술논문

目的探讨脑实质内胆脂瘤的 MRI 特征.资料与方法回顾性分析10例经手术和病理证实的脑实质内胆脂瘤的 MRI 表现,并与手术、病理结果比较.结果10例病灶均位于脑皮层或皮层下,7例居旁中线区域;形态不规则,边界清晰,7例有完整包膜;6例侵及蛛网膜下腔,其中1例同时侵及侧脑室;质地柔韧,切除后均有少许不等量的清亮液体渗出;包膜菲薄为复层鳞状上皮及少许结缔组织,内容物为不等量、分布不均的上皮碎屑、角蛋白和胆固醇;病灶周围无水肿,占位效应轻;信号不均,侵及蛛网膜下腔者以长 T1长 T2信号为主,其余4例有更多的等T1、短T1和略长T2、短T2信号;T2 FLAIR均呈高、等、低混杂信号;3例 DWI,均呈不均匀高信号;增强后 7例无强化,2例见边缘线样轻度强化,1例见内部不完整分隔样轻度强化.结论脑实质内胆脂瘤位于脑表浅部位,形态不规则,信号不均匀,弥散受限而 ADC 值高,灶周无水肿,不强化或局部轻度强化,需与脑肿瘤、脓肿及寄生虫病相鉴别.
목적탐토뇌실질내담지류적 MRI 특정.자료여방법회고성분석10례경수술화병리증실적뇌실질내담지류적 MRI 표현,병여수술、병리결과비교.결과10례병조균위우뇌피층혹피층하,7례거방중선구역;형태불규칙,변계청석,7례유완정포막;6례침급주망막하강,기중1례동시침급측뇌실;질지유인,절제후균유소허불등량적청량액체삼출;포막비박위복층린상상피급소허결체조직,내용물위불등량、분포불균적상피쇄설、각단백화담고순;병조주위무수종,점위효응경;신호불균,침급주망막하강자이장 T1장 T2신호위주,기여4례유경다적등T1、단T1화략장T2、단T2신호;T2 FLAIR균정고、등、저혼잡신호;3례 DWI,균정불균균고신호;증강후 7례무강화,2례견변연선양경도강화,1례견내부불완정분격양경도강화.결론뇌실질내담지류위우뇌표천부위,형태불규칙,신호불균균,미산수한이 ADC 치고,조주무수종,불강화혹국부경도강화,수여뇌종류、농종급기생충병상감별.
Purpose To study the MRI features of intraparenchymal cholesteatoma. Materials and Methods The MRI features of ten cases with intraparenchymal cholesteatomas were retrospectively analyzed, and compared with surgical pathology. Results All ten lesions located in cortical or subcortical regions with irregular but well-circumscribed border, of which seven were adjacent to the midline. Capsules were found in seven cases. Six cases extended into subarachnoid space, one of which extended into left lateral ventricle trigone. All the ten lesions were soft oozing small amount of clear liquid upon resection. The lesions were thin walled and lined with stratified squamous epithelium and little connective tissue. It contained misdistributed epithelial debris, keratin and cholesterol. No adjacent edema was found. There was minimal mass effect on MRI. The lesions extending into subarachnoid space were hyperintense on T2WI and hypointense on T1WI. Four cases were isointense or hyperintense on T1WI and less hyperintense or hypointense on T2WI. All lesions showed heterogeneous signal intensity on T2 FLAIR. Three patients underwent DWI showing hyperintensity. Following contrast injection, seven cases did not enhance. Two cases demonstrated slight rim enhancement, one case showed slight separation enhancement. Conclusion Intraparenchymal cholesteatoma shows characteristic MR features. It should be distinguished with brain tumor, abscess and parasitic diseases.