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目的:探讨MRI对桥小脑角(cerebellopontine angle,CPA)囊性病变的诊断及鉴别诊断价值。方法:搜集本院30例经病理证实的CPA囊性病变患者的MRI资料,回顾性分析这些病变的MRI表现,并和手术病理结果作对照分析。结果:30例病变中右侧CPA 16例,左侧10例,双侧4例;位于CPA池内24例,脑内6例。其中表皮样囊肿12例,多呈不规则形沿蛛网膜下腔匐行生长,并包埋邻近的神经血管,DWI以高信号为主,增强后无强化;蛛网膜囊肿5例,信号与脑脊液一致,增强后无强化;皮样囊肿3例,呈长T1长T2信号2例,混杂信号1例,2例DWI呈高信号,均无强化表现;囊性听神经瘤6例,呈单房或多房改变,增强后囊壁及分隔均见强化,其中3例患侧内听道扩大、听神经增粗并强化;血管母细胞瘤4例,均为大囊小结节型,附壁结节明显强化。与手术及病理对照,MRI对CPA囊性病变的定位、定性诊断准确率分别为96%、92%。结论:MRI对CPA囊性病变的定位及定性诊断准确率高,具有重要的诊断及鉴别诊断价值。
Objective: To investigate the value of MRI in the diagnosis and differential diagnosis of cystic lesions of cerebellopontine angle (CPA). Methods: The MRI data of 30 pathologically confirmed CPA cystic lesions in our hospital were collected. The MRI findings of these lesions were retrospectively analyzed and compared with the surgical pathology results. Results: Among the 30 cases, 16 cases were right CPA, 10 cases left and 4 cases bilateral. There were 24 cases in CPA pool and 6 cases in brain. The epidermoid cyst in 12 cases, mostly irregular shape along the subarachnoid growth, and embedded adjacent neurovascular, DWI high signal-based, enhanced without enhancement; arachnoid cysts in 5 cases, the signal and cerebrospinal fluid 3 cases showed long T1 long T2 signal, mixed signal 1 case, 2 cases DWI showed high signal, no enhancement; cystic acoustic neuroma in 6 cases, showed single room or Multiple room changes, enhanced posterior wall and separation were seen enhanced, including 3 cases of ipsilateral lateral enlargement of the auditory nerve, thickening and enhancement of the nerves; hemangioblastoma in 4 cases, are large capsule nodules, mural nodules Significantly strengthened. Compared with operation and pathology, the accuracy of MRI in diagnosing and treating cystic lesions of CPA was 96% and 92% respectively. Conclusion: MRI has high accuracy and accuracy for the diagnosis and differential diagnosis of cystic lesions of CPA.