1、儿童后颅窝脑肿瘤 ppt课件2/643/644/645/646/647/64Incidence and Clinical Presentation8/64Incidence and Clinical Presentation9/64Incidence and Clinical Presentation10/64Incidence and Clinical Presentation11/64Pathologic Findings12/64Pathologic Findings13/64Pathologic Findings14/64Imaging Findings15/64Imaging Fin
2、dings MRI诊断要素诊断要素16/64Imaging Findings MRI新技术新技术17/64Imaging FindingsT1WIT2WIFLAIRGd-DTPADWIADC男性男性,8岁岁,小脑蚓部髓母细胞瘤小脑蚓部髓母细胞瘤,肿瘤呈类圆形肿瘤呈类圆形,边界清晰图边界清晰图1T1WI呈略低信号呈略低信号,肿瘤前方可见弧形四脑室肿瘤前方可见弧形四脑室脑脊液信号图脑脊液信号图2同一层面同一层面T2WI呈略高信号图呈略高信号图3FLAIR呈略高信号图呈略高信号图4增强增强T1WI肿瘤呈明显对比肿瘤呈明显对比增强图增强图5DWI瘤体呈略高于脑实质信号瘤体呈略高于脑实质信号,囊变区呈低
3、信号囊变区呈低信号18/64弥散受限的机制弥散受限的机制肿瘤细胞密度高肿瘤细胞密度高细胞外间隙小细胞外间隙小肿瘤细胞的胞浆少肿瘤细胞的胞浆少核浆比例较大核浆比例较大Imaging Findings19/6420/6421/64Imaging Findings22/6423/64Imaging Findings24/64Imaging FindingsCT平扫(平扫(A、B)示左侧)示左侧小脑小脑半球半球一不规则略高密度影一不规则略高密度影(),边缘不清,其周围可),边缘不清,其周围可见带状低密度影;增强扫描见带状低密度影;增强扫描(C、D)病变强化较明显)病变强化较明显(),内见不规则点、线状
4、),内见不规则点、线状低密度区,四脑室受压、变窄,低密度区,四脑室受压、变窄,向右侧移位向右侧移位肿瘤位于小脑半球肿瘤位于小脑半球者多见于成人者多见于成人25/64治治 疗疗26/6427/64Incidence and Clinical Presentation28/64Incidence and Clinical Presentation29/64Pathologic Findings30/64Pathologic Findings镜下特点:毛样星形细胞与疏松成熟的胶质纤维混杂排列镜下特点:毛样星形细胞与疏松成熟的胶质纤维混杂排列31/64Imaging Findings32/64Imag
5、ing Findings33/64Imaging Findings34/64Imaging Findings35/64Imaging Findings36/64Imaging Findings37/64Imaging Findings小脑蚓部毛细胞星形细小脑蚓部毛细胞星形细胞瘤,肿瘤以实性为主,胞瘤,肿瘤以实性为主,呈明显不均匀强化,其呈明显不均匀强化,其内可见多发大小不等内可见多发大小不等 不不强化的囊变区强化的囊变区38/64Imaging Findings39/6440/64Incidence and Clinical Presentation41/64Incidence and Cli
6、nical Presentation42/64Pathologic Findings43/64Pathologic Findings44/64Imaging Findings45/64Imaging Findings46/64Imaging Findings47/64Imaging Findings48/64Imaging Findings49/64Imaging Findings50/6451/64Incidence and Clinical Presentation52/64Incidence and Clinical Presentation53/64Pathologic Finding
7、s54/64Pathologic Findings55/64柱状及立方细胞环绕纤维血管结缔组织柱状及立方细胞环绕纤维血管结缔组织56/64Pathologic Findings57/64Poorly differentiated choroid plexus carcinoma. Area of vascular endothelial proliferation and thickening of a connective tissue septum. 58/64Pathologic Findings59/64Imaging Findings-CT60/64Imaging Findings-
8、CTContrast-enhanced CT scan showing the tumor obviously enhanced, as well as CPA extension. 61/64Imaging Findings-MRI62/64Imaging Findings-MRISpinal drop metastasis of posterior choroid plexus papilloma63/64Imaging Findings-PET64/64Chromosomal Imbalances in Choroid Plexus Tumors65/6466/6467/6468/64I
9、ncidence and Clinical Presentation69/64Incidence and Clinical Presentation70/64Hemangioblastoma and von Hippel-Lindau71/64Pathologic Findings72/64Pathologic FindingsLow-power view of a hemangioblastoma, showing large vascular channels (open arrows) and cystic changes (closed arrows). The tumor is we
10、ll circumscribed against a rim of adjacent compressed cerebellar cortex (arrowheads). 73/64Pathologic Findings74/64Pathologic Findings75/64Pathologic Findings76/64Pathologic FindingsClassification of Hemangioblastoma77/64Imaging Findings-CT78/64Imaging Findings-CTEnhancement of the nodule 79/64Imaging Findings-MRI80/64Imaging Findings-MRIOur case 18773 赵有亭赵有亭: typical enhancement81/64Imaging Findings-MRIOur case 21391 杜耀坤杜耀坤82/64Imaging Findings-MRIOur case 21452 董梅菊董梅菊83/6484/64谢谢!