摘要
目的分析幕上实质型血管母细胞瘤(S-SHB)特征性影像及病理表现,探讨其与预后的关系。资料与方法回顾性分析经手术病理证实的11例S-SHB患者的CT、MRI影像与病理资料。影像学指标包括肿瘤部位、信号/密度、瘤周水肿、血管流空征、强化方式以及肿瘤与硬脑膜的关系等;病理指标包括肿瘤光镜下及免疫组化特征。采用Kaplan-Meier法对影像及病理因素进行预后因素筛选。结果肿瘤位置较表浅11例,位于大脑镰旁7例、大脑凸面4例,瘤周水肿明显10例。CT呈等和稍高密度5例,MRI呈T1WI稍低、T2WI稍高信号9例,瘤内或瘤周常见蚯蚓状血管流空影9例,增强呈显著强化7例,但未见脑膜尾征。光镜下肿瘤组织见致密的毛细血管网及巢状排列的间质细胞11例,免疫组化7例CD34呈强阳性、9例Vim呈强阳性表达,Ki-67表达1%~3%。随访发现2例复发。不同肿瘤部位、瘤周水肿、流空血管、免疫组化指标CD34、Vim、Ki-67对患者的无复发生存期无预测意义(P>0.05)。结论位置表浅、血管流空影及瘤周水肿明显等影像学特征是S-SHB术前诊断的重要依据。免疫组化指标CD34、Vim、Ki-67等可明确诊断,掌握其特点有助于减少误诊,提高手术安全性。
Purpose To analyze the characteristics of imaging and pathological features,and to explore its relationship with prognosis in patients with supratentorial solid hemangioblastoma(S-SHB).Materials and Methods Eleven patients with pathologically confirmed S-SHB were retrospectively collected,the CT and MRI features and pathological data were also analyzed.The imaging features were analyzed,including tumor location,intensity/density,peritumoral edema,vascular flow void,enhancement,and the relationships between tumor and endocranium.And the pathological features were evaluated,including tumor tissue performance and immunohistochemical characteristics.Kaplan-Meier survival analysis was performed to screen the prognostic factors according to imaging and pathological factors.Results S-SHB tumors were commonly located in the cerebral superficial areas(11 cases),including parafalcine region(7 cases)and the convexity of the hemispheres(4 cases).And peritumoral edema was also obvious in the S-SHB tumors(10 cases).CT showed lesions(5 cases)with isodensity and slightly hyperdensity,and MRI lesions(9 cases)presented slightly hypointensity on T1 WI and slightly hyperintensity on T2 WI.Earthworm-like vascular flow void(9 cases)was commonly showed around or within these tumor.Contrast-enhanced imagings showed significant enhancements(7 cases),without meningeal tail sign.A large amount of dense capillary networks and interstitial cells arranged between the vascular networks(11 cases)could be found within the tumor tissue via the light microscope.Immunohistochemical CD34(7 cases)and Vim(9 cases)showed strong positive expression,and Ki-67 was about 1%to 3%.Two recurrent patients were showed in the following-up.There were no significant differences in tumor location,peritumoral edema,vascular flow void,immunohistochemical parameters(CD34,Vim,Ki-67)in patients with S-SHB via survival analysis,suggesting that these factors had no predictive significance for relapse free survival(P>0.05).Conclusion The signs,such as cerebral superficial regions,vascular flow void,and prominent peritumoral edema,are important features of the preoperative diagnosis in patient with S-SHB.Immunohistochemical parameters including CD34,Vim,Ki-67 could clearly confirm the diagnosis,decreasing misdiagnose and improving security of operation.
作者
唐业欢
蒋牧良
秦宇红
李向荣
毛一朴
龙莉玲
TANG Yehuan;JIANG Muliang;QIN Yuhong;LI Xiangrong;MAO Yipu;LONG Liling(Department of Radiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第7期665-669,675,共6页
Chinese Journal of Medical Imaging
基金
广西自然科学基金项目(2019JJA140028)
广西高校中青年教师科研基础能力提升项目(2020KY03035)。
