颅内原始神经外胚层肿瘤的影像学特点分析

巨涛1，白茫茫1，王亚明2，魏铂沅2，程岗2，亓乾伟1，米良1，王涛1

(1.延安大学附属医院神经外科，陕西延安716000；2.海军总医院神经外科，北京100048)

摘要：目的探讨原始神经外胚层肿瘤(primitive neuroectodermal tumours,PNET)的影像学表现及特征，提高对该肿瘤的诊断水平。方法对14例原始神经外胚层肿瘤进行回顾性分析，总结影像学特点。结果14例患者中9例病灶位于中线附近及侧脑室旁，肿瘤边界较清楚，5例位于皮质下，10例为类圆形，瘤周水肿反应较轻；CT扫描为等或略高密度。对于肿瘤实质部分的磁共振表现，在T1加权像上11例表现为低信号或稍低信号，3例表现为等信号；在T2加权像上10例表现为等信号，4例表现为高信号或稍高信号。增强扫描时可见实性部分强化。结论PNET为高度恶性肿瘤，由于临床报告病例少，常与颅内其它肿瘤难以鉴别，通过对14例PNET影像学特点的总结，为其诊断提供科学的依据。

关键词：原始神经外胚层肿瘤；影像学

中图分类号：R739.4

作者简介：巨涛(1981—)，男，陕西咸阳人，延安大学附属医院2012级在读硕士研究生。

[收稿日期2014-12-11；责任编辑赵菊梅]

Image characteristics of intracranial primitive neuroectodermal tumors

JVTao1,BAIMang-mang1,WANGYa-ming2,WEIBo-yuan2

CHENGGang2,QIQian-wei1,MILiang1,WANGTao1

(1.Department of Neurosurgery,Affiliated Hospital of Yanan University,Yanan 716000,China;

2.Department of Neurosurgery,Navy General Hospital,Beijing 100048,China)

Abstract：Objective Discussing the imaging findings and characteristics of primitive neuroectodermal tumor (PNET) to improve the diagnostic level of the tumor.Methods 14 cases of PNET were analyzed retrospectively, and then summarized the imaging findings and feature.Results Among the 14 cases,9 patients with lesions located near the midline and lateral periventricular,tumor with clear border,5 cases located under the cortex;10 cases was round,peritumoral edema reaction which around the tumor was light.In CT scan,the tumors were mostly equidensity or slight high density.For the MRI features of PNET,11 cases showed low signal or slightly low signal in T1 weighted images,while 3 cases showed equisignal;in T2 weighted image,10 cases showed equisignal,and 4 cases showed high signal or slightly high signal.The enhancement scanning showed the visible marked enhancement of the solid mass.Conclusion Due to the less clinical cases reported,PNET is often misdiagnosed as other encephalic tumor.Based on the summary of iconography features of 14 PNET cases,this report has provided some diagnostic basis for clinical work.

Key words：Primitive neuroectodermal tumors; Iconography

原始神经外胚层肿瘤(Primitive neuroectodermal tumours,PNET)是一种罕见的、恶性程度极高的肿瘤[1]，由于国内外尚无大宗病例报导，影像学上常常与其它肿瘤难以鉴别，通过对14例经活检术后病理确诊的PNET的回顾性分析，总结其影像学特点，为临床诊断提供参考。

1资料与方法

1.1一般资料

本组病例来源于2000-01~2009-01，在海军总医院神经外科接受立体定向活检手术的患者，所有纳入病例经免疫组织化学检测，并证实为PNET。……