听神经瘤30例的MRI诊断价值.docVIP

听神经瘤30例的MRI诊断价值 [摘要] 目的 分析听神经瘤30例的磁共振成像(MRI)特点，探讨听神经瘤的MRI诊断方法及价值。方法 30例经手术及病理证实的听神经瘤，全部行磁共振T1WI、T2WI平扫及横断面、冠状面T1WI增强检查。结果 单侧肿瘤29例，双侧1例，T1WI呈略低信号25个、低等混杂信号3个、低信号3个；T2WI呈略高及高信号24个、高等信号7个；病侧 Ⅶ、Ⅷ脑神经增粗24例，增强后肿瘤呈结节状强化7 个、不均匀或环状强化24个。结论: MRI是诊断听神经瘤有效的手段，可作为听神经瘤术前首选检查方法。 [关键词]:听神经瘤 　 磁共振成像 The Diagnostic Value of MRI for Acoustic Neuroma LIU Liang-qing, ZHEN Jian-gang, ZHOU Hong-yan （Department of Radiology, Changzhou Wujin People’s Hospital, Jiangsu） Abstract Objective To investigate the diagnostic value and methods of MRI for acoustic neuroma by retrospectively analyzed the features of 30 patients with acoustic neuroma. Methods Sixteen patients who were dignosed with acoustic neuroma by operation and pathological examination underwent T1WI, T2WI transversal scans and both transversal and coronary T1WI contrast enhancement. Results There were 29 cases with unilateral acoustic neuroma and one case with bilateral acoustic neuroma, 25 tumors with relatively low signal in T1WI, 3 with low and equal complicated signals, and 3 with low signal; while 24with relatively high signal and 7 with high signal. There were 24 cases with thickened cranial Ⅶ,Ⅷ nerves located in affected side, and 7 cases with after nodular enhancement after Gd - DTPA administration, 24 cases with inhomogeneously or circularly enhanced. Conclusion MRI is an effective method in the diagnosis of acoustic neuroma, which can be the first method of choice in detecting acoustic neuroma. Key words: acoustic neuroma; magnetic resonance imaging 听神经瘤源于听神经前庭支神经鞘细胞，是桥小脑角池最常见的脑外肿瘤,约占75~80%[1]，故该区肿瘤的诊断与鉴别诊断较重要。 MRI由于具有软组织对比度好、多参数、多平面成像、无骨质伪影干扰等特点, 能更好地显示桥小脑角区和内听道的听神经瘤，笔者收集2006年1月~2009年12月间经手术和病理证实的桥小脑角区肿瘤30例, 探讨MRI对桥小脑角区肿瘤的诊断价值。　 1资料与方法 1.1 病例资料 听神经瘤30例，其中男 13例 , 女 17例，年龄 18～80岁，平均年龄51岁。临床症状主要有：（1）早期症状：①耳鸣:为一侧性，音调高低不等，渐进性加剧，多与听力减退同时开始，但也可能是早期唯一症状。②听力减退：一侧渐进性耳聋，早期常表现为与人谈话时，闻其声而不知其意，渐发展为全聋。③眩晕：少数表现为短暂的旋转性眩晕，伴耳内压迫感、恶心、呕吐，但大多数表现为不稳感。④患侧耳内深处或乳突部疼痛，外耳道后壁麻木感。（2）肿瘤侵入或原发于颅后窝的症状：面部麻木、周围性面瘫；晚期肿瘤压迫小脑则出现发声不清，运动失调，颅内压增高出现全头痛等症状。