临床医学毕业论文dwi在颅内表皮样囊肿诊断中的作用.doc

X X 大学 毕业论文 DWI在颅内表皮样囊肿诊断中的作用 姓 名：__________ 2014年6月25日 DWI在颅内表皮样囊肿诊断中的作用 【摘要】 目的 探讨磁共振（MR）弥散加权成像(DWI)、T2-液体衰减反转恢复(T2-FLAIR)在颅内表皮样囊肿诊断中的价值，着重比较二者在病灶检出以及诊断特异性中的作用。 方法 回顾性分析40例手术病理证实的颅内表皮样囊肿的术前MR常规平扫、增强和T2-FLAIR以及DWI资料。 结果 39例T1WI呈低信号，1例T1WI呈高信号，脂肪抑制像未能抑制。T2WI呈高信号，稍高于脑脊液。T2-FLAIR 囊内见不同数量的絮状稍高信号影，其中有4例仅在边缘出现少量絮状等高信号影。DWI均表现为明显高信号，信号不均匀。增强多无强化或轻度强化，其中1例发生恶性变者局部囊壁呈花环状明显强化。结论 无论在颅内表皮样囊肿病灶检出还是信号特异性方面，DWI均优于MRI平扫以及T2-FLAIR，是首选扫描技术。 【关键词】 表皮样囊肿 颅内 磁共振成像 弥散加权成像 [Abstract] Objective To evaluate the MR DWI and T2-FLAIR in the diagnosis of intracranial epidermoid cyst and compare their use in the detection of leision and diagnostic speciality. Methods 40 cases with histologically proved intracranial epidermoid cyst were performed with MRI routine scan、T1WI Gd-DTPA enhancement，T2-FLAIR and DWI. and fat-suppression T1WI were included in 1 case with hyperintensity in the mass. Results Among these cases, 39 cases were hypointensity on T1WI, and 1 case was hyperintensity. All of the cases were hyperintensity On T2WI, which was a little higher than cerebrospinal fluid. On T2-FLAIR, 30 cases were hyperintensity, while 4 cases appeared as hypointensity with patch iso- to hyper- intensity margin. All of them were hyperintensity on DWI, homogeneous or heterogeneous. All of them appeared no-enhancement or wild enhancement, except 1 case with malignant transformation shown as partial mark ring-enhancement. Conclusion DWI, which is better than MRI and T2-FLAIR in the detection of leisions and speciality of sign, is the first choice for canning. [Key words] epidermoid cyst; intracranial; magnetic resonance imaging; diffusion-weighted imaging 表皮样囊肿是一种良性肿瘤，因其内容物不同，影像学检查表现各异，因此诊断有一定的困难。笔者根据临床实践，回顾性分析2005年1月～2007年12月40例经手术病理证实的颅内表皮样囊肿术前MRI检查资料，包括常规平扫（T1WI、T2WI）、增强T1WI、T2-FLAIR、DWI，着重分析MRI各扫描序列尤其是DWI在表皮样囊肿病灶检出以及诊断特异性中的价值。 材料与方法 研究对象：颅内表皮样囊肿40例（其中1例发生恶性变），其中男性25例，女性15例；年龄20～55岁，平均年龄34岁。 扫描方法：术前均行MRI扫描，采用Philips achieva 1.5双梯度MR扫描仪，SENSE-