Sousa Rita, Sá Graça, Reimão Sofia, Lopes Leonor, Ruivo Joana, Albuquerque Luísa, Campos Jorge
Serviços de Imagiologia Neurológica e de Neurologia, Hospital Universitário de Santa Maria, Lisboa, Portugal.
Acta Med Port. 2006 Nov-Dec;19(6):466-70. Epub 2007 May 14.
Medulloblastoma is a brain tumor of neuroepithelial origin, frequent in children but rare in adults. The imaging pattern is well studied in the pediatric group thought there is controversy about the imaging characteristics in adults. We report CT and MRI imaging findings of 8 adult patients with cerebellar medulloblastoma. The mean age was 29.6 years (16-65 years). The male: female rate was 5:3. Most were lateral, located in the cerebellar hemisphere (63%). They were hyperdense on CT (67%). On the MRI they were all hypointense on T1, hyperintense on T2, with gadolinium enhancement of variable pattern. In 7 cases there were cysts/intratumoral necrosis. It was seen calcifications in 2 cases. Four patients presented hydrocephalus. In 2 cases there was no perilesional edema. All had well defined margins and superficial extension. Dural involvement was seen in 7, one of which with lateral venous sinus compromise, and brainstem invasion was seen in 1 case. The imaging findings of medulloblastomas in adults are unspecific and different from those in child. They should be considered in the differential diagnosis of cerebellar tumor in adults, especially if they are hyperdense on CT, with well defined margins, with superficial extension and with dural involvement.
髓母细胞瘤是一种起源于神经上皮的脑肿瘤,在儿童中常见但在成人中罕见。虽然成人髓母细胞瘤的影像学特征存在争议,但小儿组的影像学表现已得到充分研究。我们报告了8例成人小脑髓母细胞瘤的CT和MRI影像学表现。平均年龄为29.6岁(16 - 65岁)。男女比例为5:3。大多数肿瘤位于外侧,位于小脑半球(63%)。CT表现为高密度(67%)。MRI表现为T1加权像均为低信号,T2加权像为高信号,钆增强模式各异。7例有囊肿/瘤内坏死。2例可见钙化。4例患者出现脑积水。2例无瘤周水肿。所有肿瘤边界清晰且有表面延伸。7例可见硬脑膜受累,其中1例伴有外侧静脉窦受压,1例可见脑干侵犯。成人髓母细胞瘤的影像学表现不具有特异性,与儿童不同。在成人小脑肿瘤的鉴别诊断中应考虑到这些表现,尤其是那些CT表现为高密度、边界清晰、有表面延伸且有硬脑膜受累的肿瘤。