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颅内血管周细胞瘤fMRI及病理组织学特征分析[J]. 肿瘤防治研究, 2012, 39(12): 1482-1486. DOI: 10.3971/j.issn.1000-8578.2012.12.018
引用本文: 颅内血管周细胞瘤fMRI及病理组织学特征分析[J]. 肿瘤防治研究, 2012, 39(12): 1482-1486. DOI: 10.3971/j.issn.1000-8578.2012.12.018
Functional MRI and Histopathology of Intracranial Hemangiopericytomas[J]. Cancer Research on Prevention and Treatment, 2012, 39(12): 1482-1486. DOI: 10.3971/j.issn.1000-8578.2012.12.018
Citation: Functional MRI and Histopathology of Intracranial Hemangiopericytomas[J]. Cancer Research on Prevention and Treatment, 2012, 39(12): 1482-1486. DOI: 10.3971/j.issn.1000-8578.2012.12.018

颅内血管周细胞瘤fMRI及病理组织学特征分析

Functional MRI and Histopathology of Intracranial Hemangiopericytomas

  • 摘要: 目的 回顾分析颅内血管周细胞瘤(hemangiopericytomas,HPCs)的常规和功能MR成像表现及病理组织学特点,以提高其影像诊断的准确率。方法收集7例经病理证实的颅内HPCs(intracranial hemangiopericytomas),应用3.0T MRI行常规MRI及弥散加权成像、灌注成像和MRS,分析其特征性的MR表现和组织病理学特点。结果HPCs 7例均为脑外肿瘤,可幕上、幕下及跨幕上幕下生长。病变体积均较大[平均(6.3±1.2)cm],形态不规则,多数呈分叶状(6例),以窄基底附着硬膜上,肿瘤内及肿瘤中央显示血管流空信号4例,囊变和坏死6例。T1WI、T2WI及T2WI-Flair均呈混杂信号,增强呈明显强化,瘤周有轻-中度水肿。DWI呈混杂高信号[ADC值(1.15±0.36)],PWI显示瘤体实质部分呈明显高灌注,rCBV (7.52±1.93),rCBF (8.73±1.78),MTT(1.62±0.29)。瘤体液化坏死区呈低灌注或灌注缺失,瘤周水肿呈低灌注。MRS显示实性区域Cho峰显著增高,NAA峰明显减低或缺如,Cho/NAA及Cho/Cr 比值均明显增高,MI峰及Lac峰高耸,MI /N MI(正常侧MI),Lac/Cr明显升高,未见Ala峰显示。病理组织切片显示瘤内富含鹿角状血管,将瘤细胞分割成小叶状,瘤细胞呈卵圆形,由丰富的网状纤维围绕。7例均显示CD34(+),5例EMA(-),5例PR(-),5例SMA(-),4例GFAP(-),4例S-100(-)。Ki-67≤5% 3例,≤10% 2例,≤20% 2例。结论颅内HPCs的形态学表现以及DWI、PWI和MRS均有一定特征,与病理组织学特点有一定的相关性,多种MRI技术联合应用对其诊断及鉴别有非常重要的价值。

     

    Abstract: Objective To evaluate the normal and advanced MR features, pathological features of intracranial hemangiopericytomas in order to improve its diagnostic accuracy. Methods The normal and advanced MRI findings, pathological findings of 7 cases with intracranial hemangiopericytomas verified by pathology were retrospectively analyzed. Results MRI features of intracranial HPC included: 7 cases all were Outside brain parenchyma with average diameter (6.3±1.2) cm of focus area. Among the 7 cases, 6 of the cases were multilobulated, 7 were narrow based with dural, 4 had serpentine signal voids, and 6 had cystic degeneration or necrosis. The mix-intensity of T1WI, T2WI and T2WI-Flair markedly enhancement, showing a mild-moderate peritumoral edema around the tumor. The results from hyper-heterogenous intensity of DWI[ADC value was (1.15±0.36)] and of PWI [rCBV was (7.52±1.93); rCBF was (8.73± 1.78); and MTT was (1.62±0.29)]demonstrated a high perfusion in the tumor. The necrosis area showed low perfusion or no perfusion, while the peritumoral edema showed low perfusion. The results from MRS demonstrated that Cho/NAA, Cho/Cr, MI /N MI(normal MI) and Lac/Cr have significantly become higher and NAA /Cr has significantly become lower. Pathologically, tumors contained a large number of staghorn vessels with separated lobulations, oval shape tumor cells, and rich reticular fibers. Immunohistochemisty: 7 cases CD34(+), 5 cases EMA (-), 5 cases PR(-), 5 cases SMA(-), 4 cases GFAP(-),4 cases S-100 (-). Ki-67 ≤5% 3 cases, ≤10% 2 cases, and ≤ 20% 2 cases. Conclusion The morphology changes exhibited correlations with the information based on DWI, PWI and MRS for the patients with intracranial hemangiopericytomas. Thus, the application of multiple MIR plays an important role in the diagnosis and identification of intracranial hemangiopericytomas.

     

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