电邮这篇文章 原发性脑外肿瘤磁核磁共振成像误诊：临床病例系列
- 作者: Surovcev E.N.1,2, Kapishnikov A.V.1
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隶属关系:
- Samara State Medical University
- Dr. Sergey Berezin Medical Institute (MIBS)
- 期: 卷 5, 编号 3 (2024)
- 页面: 642-655
- 栏目: 临床病例及临床病例的系列
- URL: https://ogarev-online.ru/DD/article/view/310046
- DOI: https://doi.org/10.17816/DD626158
- ID: 310046
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原发性脑外肿瘤是脑膜和颅神经的良性和恶性肿瘤。其术前鉴别诊断基于核磁共振成像（MRI）符号学分析。对这类肿瘤进行分类的关键点在于以下特征：增生形成的结构、对比度的性质、增生与脑组织的分界、是否与脑膜或颅神经相互连接。
在大多数具有典型符号学特征的病例中，根据核磁共振成像数据的视觉分析对各种类型的原发性脑外肿瘤进行鉴别诊断并不困难。在核磁共振成像表现不典型的情况下，很难可靠地区分肿瘤。在这种情况下，最大的困难在于区分不同恶性程度的脑膜瘤，区分单发性纤维瘤和脑膜瘤，以及位于脑桥小脑角肿瘤的类型确定。
本文介绍了一系列观察结果，其中包括基于核磁共振成像数据对原发性脑外肿瘤进行鉴别诊断时误诊的最典型情况。所有呈现的增生形成物均经过术后组织学检查验证。
经临床实例分析表明，考虑符号学的总体特征可以减少误诊的数量。
作者简介
Evgeniy N. Surovcev
Samara State Medical University; Dr. Sergey Berezin Medical Institute (MIBS)
编辑信件的主要联系方式.
Email: evgeniisurovcev@mail.ru
ORCID iD: 0000-0002-8236-833X
SPIN 代码: 5252-5661
Scopus 作者 ID: 57224906215
MD
俄罗斯联邦, Samara; TogliattiAleksandr V. Kapishnikov
Samara State Medical University
Email: a.v.kapishnikov@samsmu.ru
ORCID iD: 0000-0002-6858-372X
SPIN 代码: 6213-7455
Scopus 作者 ID: 6507900025
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, Samara参考
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Fig. 1. Heterogeneity of structure and heterogeneity of contrasting of benign meningioma. On magnetic resonance imaging, signs of a cyst (arrow) are similar to manifestations of necrosis.
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Fig. 2. Heterogeneity of the structure of benign meningioma. The hemorrhage zone (arrow) imparts pronounced heterogeneity to the tumor structure.
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Fig. 3. Heterogeneity of contrast enhancement of benign meningioma. In some cases, benign meningiomas slightly and heterogeneously increase their signal characteristics after contrast enhancement (arrow).
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Fig. 4. The absence of a cerebrospinal fluid gap between a benign meningioma and the brain tissue, and the presence of peripheral edema can be interpreted as tumor invasion: a — T2-WI; b — T1-CE. A benign meningioma is shown (*). The cerebrospinal fluid gap is visible only in the posterior sections (black arrows). In the anterior sections, the border between the tumor and the brain tissue is not visible; peripheral edema is determined in this area (white arrows).
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Fig. 5. Atypical manifestations of malignant meningioma on magnetic resonance imaging: a — T2-WI; b — T1-WI; c — T1-CE. A malignant meningioma (*) located in the epiphyseal region is shown. Tumor invasion into the splenium of the corpus callosum is determined (arrow).
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Fig. 6. Difficulty in determining the relationship of a tumor with a cranial nerve or meninges: a — neurinoma with no visual relationship with cranial nerves (the arrow shows the “intact” VII and VIII nerves in the internal auditory canal); b — meningioma with signs of a tumor connection with cranial nerves (arrow).
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Fig. 7. Solitary fibrous tumor with MRI semiotics similar to benign meningioma: a — T2-WI; b — T1-WI; c — T1-CE. An extracerebral formation is determined in the anterior parts of the interhemispheric fissure (*).
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Fig. 8. Solitary fibrous tumor with similar magnetic resonance imaging semiotics to malignant meningioma: a — T2-WI; b —T1-WI; c — T1-CE.
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