Jinhu Y, Jianping D, Xin L, Yuanli Z
Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
AJNR Am J Neuroradiol. 2008 Mar;29(3):577-81. doi: 10.3174/ajnr.A0845. Epub 2007 Dec 7.
The reported MR imaging characteristics of cavernous sinus cavernous hemangiomas (CSCHs) in the literature are nonspecific. The purpose of our study was to explore dynamic enhancement features of CSCHs on conventional contrast-enhanced MR imaging and to correlate these features with histopathologic subtypes.
Twenty-one patients (8 male and 13 female; age range, 13-63 years; average age, 42.6 years) with surgically confirmed CSCHs were retrospectively investigated. Preoperative MR study was performed in all cases, consisting of T1-weighted axial imaging, T2-weighted axial imaging, T1-weighted sagittal imaging, and contrast-enhanced T1-weighted axial, sagittal, and coronal images.
There were 4.8% (1/21) that showed homogeneous enhancement on all 3 contrast-enhanced sequences, whereas 95.2% (20/21) demonstrated heterogeneous enhancement on the first contrast-enhanced sequence. Among the 20 lesions, on subsequent contrast-enhanced sequences, 55.0% (11/20) showed homogeneous enhancement, whereas 35.0% (7/20) of lesions showed progressive contrast "filling in." The remaining 10% (2/20) exhibited no apparent enhancement changes. The 95.2% (20/21) of lesions with heterogeneous enhancement on the first contrast-enhanced sequence correlated with type B or type C pathologic findings, whereas 4.8% (1/21) with homogeneous enhancement correlated with type A pathologic findings. Among the 20 type B or type C lesions, 80% (16/20) achieved total or near-total resection.
Progressive contrast "filling in" in the tumors on conventional contrast-enhanced MR images can aid in differentiating between cavernous sinus lesions and suggest the diagnosis of cavernous hemangiomas.
文献报道的海绵窦海绵状血管瘤(CSCHs)的磁共振成像特征缺乏特异性。本研究的目的是探讨CSCHs在传统对比增强磁共振成像上的动态增强特征,并将这些特征与组织病理学亚型相关联。
回顾性研究21例经手术证实为CSCHs的患者(8例男性,13例女性;年龄范围13 - 63岁,平均年龄42.6岁)。所有病例均进行了术前磁共振检查,包括T1加权轴位成像、T2加权轴位成像、T1加权矢状位成像以及对比增强T1加权轴位、矢状位和冠状位图像。
4.8%(1/21)的病变在所有3个对比增强序列上均表现为均匀强化,而95.2%(20/21)在第一个对比增强序列上表现为不均匀强化。在这20个病变中,在后续对比增强序列上,55.0%(11/20)表现为均匀强化,35.0%(7/20)的病变表现为对比剂逐渐“填充”。其余10%(2/20)无明显强化变化。在第一个对比增强序列上表现为不均匀强化的病变中有95.2%(20/21)与B型或C型病理结果相关,而表现为均匀强化的4.8%(1/21)与A型病理结果相关。在20个B型或C型病变中,80%(16/20)实现了完全或接近完全切除。
传统对比增强磁共振图像上肿瘤内对比剂逐渐“填充”有助于鉴别海绵窦病变并提示海绵状血管瘤的诊断。