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目的 探讨MRI增强检查诊断桥小脑角肿瘤的价值。方法 研究 6 8例手术和病理证实的桥小脑角肿瘤的资料 ,其中听神经瘤 34例 ,三叉神经瘤 5例 ,脑膜瘤 2 0例 ,胆脂瘤 9例。所有病人均作了增强前后的MR扫描 ,包括轴位、矢状位和冠状位。结果 34例听神经瘤中 ,2 3例增强呈结节 -环状、多环状、花环状肿块 ,囊变率 6 8% ;11例呈均匀肿块 ;34例显示面听神经束增粗强化与肿瘤相连 ,其中呈“荸荠”征 15例 ,为听神经瘤的典型征像。 5例三叉神经瘤强化呈结节 -环状、或多环状 3例 ,哑铃状 2例 ,5例患侧三叉神经均显示不清 ,同侧面听神经受压。 2 0例脑膜瘤中度强化均匀肿块 ;“脑膜尾”征 11例 ,同侧面听神经束鞘膜强化、不增粗 5例。 9例胆脂瘤长T2 、长T1与脑脊液一致 ,T1低信号中有比脑脊液信号稍高的组织 ,无强化表现 ,病变沿蛛网膜下腔扩展 ,基底动脉包埋 5例。结论 MRI增强检查能显示听神经瘤、三叉神经瘤、脑膜瘤、胆脂瘤的特征表现 ,诊断桥小脑角肿瘤有独特的价值。
Objective To investigate the value of enhanced MRI in the diagnosis of cerebellopontine angle tumors. Methods Sixty-eight cases of cervicocerebral angle tumors confirmed by surgery and pathology were studied. Among them, there were 34 cases of acoustic neuroma, 5 cases of trigeminoma, 20 cases of meningiomas, and 9 cases of cholesteatoma. All patients underwent pre- and post-enhancement MR scans, including axial, sagittal and coronal positions. Results Of the 34 cases of acoustic neuroma, 23 cases showed nodular-annular, multiannual, annular masses, and the cystic degeneration rate was 68%; 11 cases showed homogeneous mass; 34 cases showed thickening and enhancement of auditory nerve bundles. The tumors were connected, and there were 15 cases of “deafness”, which were typical signs of acoustic neuroma. 5 cases of trigeminal neuroma enhanced nodular-annular or polycyclic in 3 cases, dumbbell in 2 cases, 5 cases of trigeminal nerve in the affected side are unclear, with the side of the auditory nerve compression. Twenty patients with meningiomas had moderately enhanced homogeneous masses; “meningeal tail” signs were seen in 11 patients, and the auditory nerve bundle sheaths were reinforced and not thickened in 5 patients. 9 cases of long-term T2 and long T1 of cholesteatoma were consistent with cerebrospinal fluid. T1 low signal had slightly higher signal than cerebrospinal fluid, no enhanced performance, lesions spread along subarachnoid space, and basilar artery was embedded in 5 cases. Conclusions MRI-enhanced examination can show the characteristics of acoustic neuroma, trigeminoma, meningioma, and cholesteatoma, and has unique value in the diagnosis of cerebellopontine angle tumors.