CAJ | 학술논문

目的：探讨幕上原始神经外胚层肿瘤（sPNET）的MRI及病理特点，提高对本病的认识。方法回顾性分析经手术病理证实的22例sPNET的MRI和组织病理学特点，并结合文献进行分析。结果22例sPNET中20例为单发病灶，弥漫浸润和多灶性病变各1例。肿瘤多位于大脑半球皮层下，呈类圆形和分叶状、边界较清晰，瘤周水肿轻或无水肿为主。M RI上15例可见明显囊变、11例可见出血，肿瘤实性部分在 T1 WI呈稍低信号或中等信号；T2 WI呈中等信号或稍高信号，68．4％的ADC值减低。增强扫描77．3％的有明显强化。病理上sPNET由致密小圆细胞构成，浸润性生长，部分形成菊形团，17例可见出血坏死，免疫组化示多种神经源性标记物阳性表达。结论 sPNET 的MRI表现能反映其组织病理学特征，有助于sPNET的诊断和鉴别。
목적：탐토막상원시신경외배층종류（sPNET）적MRI급병리특점，제고대본병적인식。방법회고성분석경수술병리증실적22례sPNET적MRI화조직병이학특점，병결합문헌진행분석。결과22례sPNET중20례위단발병조，미만침윤화다조성병변각1례。종류다위우대뇌반구피층하，정류원형화분협상、변계교청석，류주수종경혹무수종위주。M RI상15례가견명현낭변、11례가견출혈，종류실성부분재 T1 WI정초저신호혹중등신호；T2 WI정중등신호혹초고신호，68．4％적ADC치감저。증강소묘77．3％적유명현강화。병리상sPNET유치밀소원세포구성，침윤성생장，부분형성국형단，17례가견출혈배사，면역조화시다충신경원성표기물양성표체。결론 sPNET 적MRI표현능반영기조직병이학특정，유조우sPNET적진단화감별。
Objective To analyze MRI feature and pathological findings of supratentorial primitive neuroectodermal tumors (sPNET) ,and improve the diagnosis .Methods The MRI findings and histopathological features of 22 cases with sPNET proved by pathology were analyzed retrospectively and combined with literature .Results Twenty cases showed single intracranial mass ,one case with diffuse lesion ,and one with multiple lesions .On MRI ,Most tumors were localized in cerebral subcortex ,presented as round or lobulated masses with well‐demarcated margins ,and with mild or no peritu‐moral edema .Large cystic and necrotic portions in tumors were seen in 15 cases ,and focal intratumoral hemorrhage were seen in 11 cases .The solid portion of tumors showed slightly hypointense to isointense on T1‐weighted images ,and isoin‐tense to slightly hyperintense on T2‐weighted images .The solid portion of tumors showed low ADC value in 13/19 cases . On post‐contrast imaging ,77 .3 percent tumors showed marked inhomogeneous enhancement .On microscopic examina‐tion ,necrosis were seen in 17 cases ,the tumors composed of small round to oval small cells with hyperchromatic nuclei and spread invasively ,some of the tumor cells appeared as rosettes .Most cases showed multiple neurogenous maker ex‐pression on immunohistochemistry assay .Conclusion The MRI appearance of sPNET could reflect its histopathology fea‐tures ,and helpful to the diagnosis and differentiation from other brain tumors .