颅内血管平滑肌瘤的影像表现(附2例讨论)

目的探讨颅内血管平滑肌瘤的CT及MRI表现。资料与方法结合文献回顾性分析2例经手术病理证实的位于颅内鞍旁的血管平滑肌瘤的CT及MRI表现。2例均行MRI平扫及增强,1例行MRI动态增强,1例行CT平扫。结果 2例均位于右侧鞍旁。例1行CT平扫示中颅窝鞍旁类圆形稍高密度肿块,密度均匀,周围未见水肿,MRI平扫T1WI呈低信号,扩散加权成像(DWI)呈低信号,T2WI呈不均高信号,内可见条状低信号。病灶周围见薄层环状水肿带,增强扫描肿块明显均匀强化,局部可见脑膜尾征;例2 MRI平扫示鞍旁卵圆形肿块,T1WI呈等信号,T2WI呈高信号,右三叉神经受压,增强扫描早期示病灶中心斑片状强化,增强晚期示病灶逐渐从中心向周边强化。结论动态增强扫描呈中心性渐进性强化可能为颅内血管平滑肌瘤特征性表现,有助于其诊断与鉴别诊断。

Imaging Features of Intracranial Angioleiomyoma(2 Cases Discussion)

Objective To investigate the CT and MR features of intracranial angioleiomyoma.Materials and MethodsThe CT and MR features of 2 cases with intracranial parasellar angioleiomyomas proved pathiologically were analyzed retrospectively.2 cases received plain and postcontrast MRI scan,dynamic enhanced MR scan was performed in 1 case,plain CT was performed in 1 case.ResultsThe two cases were located in the right parasellar region.In case one,an oval homogeneous slight high density mass without peripheral edema was seen at parasellar region of the middle cerebral fossa on plain CT,hypointenstiy on T1W and DWI and heterogeneous hyperintensity on T2W with central patchy hypointensity and thin layer edema circle around the tumor were noted on plain MR,and marked homogeneous enhancement with dural tail sign was revealed on enhanced MR.In case two,an oval tumor with compression of the right trigeminal nerve showed isointensity on T1WI and hyperintensity on T2WI,central patchy enhancement of the tumor on early enhanced MR and gradual enhancement extended from the central portion to the surrounding area on late enhanced MR were identified.ConclusionGradually enhancement with a tendency from the central portion to the surrounding area may be a specific feature of intracranial angioleiomyoma,which will be very helpful for diagnosis and differential diagnosis.