鞍旁海绵状血管瘤的MRI表现及误诊分析
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摘要
目的探讨鞍旁海绵状血管瘤的MRI表现及误诊原因。方法回顾性分析经手术证实的12例鞍旁海绵状血管瘤MRI平扫及增强扫描资料,观察病灶分布、边界、部位及MRI信号表现。结果 12例病灶均为单发,边界清,7例位于左侧鞍旁,5例位于右侧鞍旁。与脑白质相比,T_1WI上5例病灶呈等信号,7例呈稍低信号,11例信号均匀,1例信号不均匀;T_2WI上12例病灶均呈高信号,11例信号均匀,1例信号不均匀。DWI(b=1000 s/mm~2)上弥散不受限。增强扫描12例病灶均呈显著强化。术前MRI正确诊断6例,误诊6例。结论鞍旁海绵状血管瘤的MRI表现具有特征性,提高对本病的认识有助于术前明确诊断。
Objective To summarize the MRI findings of the cavernous angioma beside sella tursica and investigate the reason of the misdiagnosis.Methods Retrospective analysis the MRI findings of the 12 cases surgically verified cavernous angioma beside sella tursica,all cases were performed by precontast and postcontast MRI scanning.Results 12 lesions were solitary,clear boundary,7 cases were located in left parasellar and 5 cases in the right parasellar.Compared with the brain white matter,5 cases were iso-intensity and 7 cases were slightly hypointense on T_1WI,only one case were uneven.12 cases were hyperintense on T_2WI,one case were uneven.12 cases diffusion were not limited on DWI(b =1000 s/mm~2).12 cases marked homogeneous enhancement after contrast material administration.Preoperative MRI correctly diagnosed 6 cases,6cases were misdiagnosed.Conclusion There are several characteristics MRI features in cavernous angioma beside sella tursica,rising recognition of this disease is very helpful to make a definite diagnosis.
Objective To summarize the MRI findings of the cavernous angioma beside sella tursica and investigate the reason of the misdiagnosis.Methods Retrospective analysis the MRI findings of the 12 cases surgically verified cavernous angioma beside sella tursica,all cases were performed by precontast and postcontast MRI scanning.Results 12 lesions were solitary,clear boundary,7 cases were located in left parasellar and 5 cases in the right parasellar.Compared with the brain white matter,5 cases were iso-intensity and 7 cases were slightly hypointense on T_1WI,only one case were uneven.12 cases were hyperintense on T_2WI,one case were uneven.12 cases diffusion were not limited on DWI(b =1000 s/mm~2).12 cases marked homogeneous enhancement after contrast material administration.Preoperative MRI correctly diagnosed 6 cases,6cases were misdiagnosed.Conclusion There are several characteristics MRI features in cavernous angioma beside sella tursica,rising recognition of this disease is very helpful to make a definite diagnosis.
引文
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8 秦越,杜滂,李金柱,等.MRI在鞍旁海绵状血管瘤与脑膜瘤鉴别诊断中的应用[J].实用放射学杂志,2012,28:233-235.
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12 赵珊珊,程敬亮,张勇.磁共振成像在诊断颅内海绵状血管瘤中的应用价值[J].临床放射学杂志,2012,31:167-171.
2 Fraser JF,Mass AY,Brown S,et al.Transnasal endoscopic resection of a cavernous sinus hemangioma:technical note and review of the literature[J].Skull Base,2008,18:309-315.
3 周良辅,毛颖,陈亮.海绵窦海绵状血管瘤的诊断和治疗[J].中华神经外科疾病研究杂志,2003,2:12-15.
4 鱼博浪,王斐,孙亲利,等.鞍旁海绵状血管瘤的CT和MRI诊断[J].临床放射学杂志,2007,26:217-219.
5 Sohn CH,Kim SP,Kim IM,et al.Characteristic MR Imaging Findings of Cavernous Hemangiomas in the Cavernous Sinus[J].AJNR,2003,24:1148-1151.
6 Ye Jh,Dai JP,Li X,et al.Dynamic enhancement features of cavernous sinus cavernous hemangiomas on conventional contrast-enhanced MR imaging[J].AJNR,2008,29:577-581.
7 Hasiloglu ZI,Asik M,Kizilkilic O,et al.Cavernous hemangioma of the cavernous sinus misdiagnosed as a meningioma:a case report and MR imaging findings[J].Clin Imaging,2013,37:744-746.
8 秦越,杜滂,李金柱,等.MRI在鞍旁海绵状血管瘤与脑膜瘤鉴别诊断中的应用[J].实用放射学杂志,2012,28:233-235.
9 Momoshima S,Shiga H,Yuasa Y,et al.MR findings in extra cranial cavernous angiomas of the middle cranial fossa[J].AJNR,1991,12:756-760.
10 Rivera PP,Willinsky RA,Porter PJ.Intracranial cavernous malformations[J].Neuroimagingm Clin N Am,2003,13:27-40.
11 Dammann P,Barth M,Zhu Y,et al.Susceptibility weighted magnetic resonance imaging of cerebral cavernous malformations:prospects,drawbacks,and first experience at ultra-high field strength(7-Tesla)magnetic resonance imaging.Neurosurg Focus,2010,29:E5
12 赵珊珊,程敬亮,张勇.磁共振成像在诊断颅内海绵状血管瘤中的应用价值[J].临床放射学杂志,2012,31:167-171.