易误诊为神经肿瘤的一种疾病——肿块型中枢神经系统原发性血管炎

背景与目的：由于缺乏特异性临床和影像表现，肿块型中枢神经系统原发性血管炎（primary angiitris of central nervous system，PACNS）常被误诊为胶质瘤．本文旨在探讨肿块型PACNS的诊断与鉴别诊断。方法：回顾性分析手术治疗的37例肿块型PACNS患者的临床及影像表现。结果：85．3％的患者出现局灶性神经功能减退，55．9％患者有不同程度皮层高级功能减退症状。70．6％的颅内病变累及脑皮层：73．5％患者的正常区域脑血管周围间隙增宽，其中76％出现血管强化；病变出现特征性的“C”形强化。结论：局灶性神经功能和高级功能减退、病变累及皮层和“C”形强化等特征．有助于诊断肿块型PACNS。

The Mass Lesions of Primary Angiitis: an Analysis of 37 Cases

BACKGROUND & OBJECTIVE: Primary angiitis of central nervous system (PACNS) may be misdiagnosed as glioma. This study was to investigate the diagnostic criteria and differential diagnosis for a mass lesion of PACNS. METHODS: Radiological and clinical features of 37 patients with mass lesion of PACNS were analyzed retrospectively. RESULTS: Focus dysfunctional symptoms of CNS was present in 85.3% of the patients with mass lesion of PACNS, and dysfunctions of advanced cortex was present in 55.9% of the patients. Cerebral cortex was involved in 70.6% of mass lesions of PACNS. Virchow-Robin perivascular spaces were enlarged in normal areas in 73.5% of the hemisphere and the vessels were simultaneously enhanced in 76% of the patients. The typical C-shape enhanced focuses were found on MRI in the patients with mass lesion of PACNS. CONCLUSIONS: The diagnosis for the mass lesion of PACNS may be improved by clinical and radiological features.