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目的探讨间变型血管周细胞瘤(AHPC)的MRI影像学表现,以提高其诊断准确率。方法回顾性分析8例经手术病理证实的AHPC患者的临床、病理及MRI资料。结果肿瘤呈分叶状(6例)、不规则形(1例)、跨叶生长(1例)。MR平扫T1WI呈等、稍低信号6例,混杂信号2例;T2WI呈等、稍高信号6例,混杂信号2例;增强扫描肿瘤实性部分均明显强化;明显囊变坏死4例,“脑膜尾征”2例,相邻颅骨破坏1例,瘤周水肿明显4例,7例与硬脑膜以相对窄基底相连。所有病例内部及周边均可见数量不等的血管影。结论 AHPC具有明显的分叶状、跨叶生长倾向,肿瘤易出血、囊变、坏死,“脑膜尾征”少见,易破坏邻近颅骨,瘤周水肿明显等特点,但需与恶性脑膜瘤及WHOⅡ级血管周细胞瘤相鉴别。
Objective To investigate the MRI findings of anaplastic perivascular neoplasms (AHPCs) to improve the diagnostic accuracy. Methods The clinical, pathological and MRI data of 8 patients with pathologically confirmed AHPC were retrospectively analyzed. Results The tumor was lobulated (6 cases), irregular (1 case) and transmembrane (1 case). MR plain T1WI was equal, slightly lower signal in 6 cases, mixed signal in 2 cases; T2WI was equal, slightly higher signal in 6 cases, mixed signal in 2 cases; enhanced solid tumors were significantly enhanced; obvious capsule necrosis in 4 cases, 2 cases of “meningeal sign”, 1 case of adjacent skull destruction, 4 cases of peritumoral edema, 7 cases of dura with a relatively narrow basement. All cases were visible inside and around the varying amount of blood vessels shadow. Conclusions AHPC has the characteristics of obvious leaflet and leaflet growth, easy bleeding of hemorrhage, cystic degeneration and necrosis, rare epilepsy, easy destruction of adjacent skull and obvious peritumoral edema. However, And WHO Ⅱ grade pericytes differentiate.