医学精品课件：脑肿瘤（八年制-1时）.ppt

1、肿瘤影像诊断华中科技大学同济医学院同济医院放射科 Zhu Wenzhen M.D.Prof.The 2007 WHO Classification of Tumours of the Central Nervous Systemu星形细胞肿瘤星形细胞肿瘤(Astrocytic tumors)u少突胶质细胞肿瘤少突胶质细胞肿瘤（Oligodendroglial tumours）u少突星形细胞肿瘤少突星形细胞肿瘤（Oligoastrocytic tumours）u室管膜肿瘤室管膜肿瘤（Ependymal tumours）u脉络丛肿瘤脉络丛肿瘤（Choroid plexus tumours）u其它神

2、经上皮类肿瘤其它神经上皮类肿瘤（Other neuroepithelial tumours）u神经元和混合性神经元神经元和混合性神经元-神经胶质肿瘤神经胶质肿瘤 （Neuronal and mixed neutonal-glial tumours）u松果体区肿瘤松果体区肿瘤（Tumourl of the pineal region）u胚胎类肿瘤胚胎类肿瘤（Embryonal tumours）u许旺氏细胞瘤（神经鞘膜瘤，神经鞘瘤)（Schwannoma(neurilemoma,neurinoma)u神经纤维瘤（Neurofibroma)u神经束膜瘤 （Perineurioma）u恶性周围神经鞘瘤

3、 (Malignant peripheral nerve sheath tumour，MPNST)u脑脊膜上皮细胞肿瘤脑脊膜上皮细胞肿瘤（Tumours of meningothelial cells）Meningiomau脑膜间质肿瘤脑膜间质肿瘤(Mesenchymal tumours)u原发性黑色素细胞病变原发性黑色素细胞病变（Primary melanocytic lesions）u与脑膜相关的其他类肿瘤与脑膜相关的其他类肿瘤（Other neoplasms related to the meninges）u恶性淋巴瘤（Malignant lymphomas）u浆细胞瘤（Plasmacy

4、toma）u粒细胞肉瘤（Granulocytic sarcoma）u生殖细胞瘤（Germinoma）u胚胎性癌（Embryonal carcinoma）u卵黄囊性瘤（Yolk sac tumour）u绒毛膜癌（Choriocarcinoma）u畸胎瘤（Teratoma）u混合性生殖细胞肿瘤（Mixed germ cell tumour）u颅咽管瘤(Craniopharyngioma)u颗粒细胞瘤（Granular cell tumour）u垂体细胞瘤（Pituicytoma）*u腺垂体梭形细胞嗜酸性细胞瘤*（Spindle cell oncocytoma of the adenohypophy

5、sis）星形细胞瘤（星形细胞瘤（astrocytoma）uThe most common intracranial tumor.uAccount for 60%of all primary brain tumors.uSupratentorial glioma in adults Infratentorial glioma(cerebellum or brain stem)in children)Astrocytomau Circumscribed Astrocytoma(benign,I)u Grade II Astrocytomau Anaplastic(Malignant)astrocy

6、toma(III)u Glioblastoma multiforme(IV)Low-grade astrocytomau Pathology Either focal/well-delineated or diffusely infiltrating Kernohan grades I-II,WHO grade II.uIncidence 10%to 15%of astrocytomauAge Children and young adults(2040ys)uLocation Cerebral hemispheres,cerebellum,brain stem.CT/MRI：uNECT:Fo

7、cal/diffuse mass,hypodensityuMRI:Low SI on T1WI,high SI on T2WIuno enhancement or minimal E.Type of enhancement may be focal,nodular.u margin is clear or obscure.uCalcification:uncommonuHemorrhage:rare.uEdema and mass effect usually minimal or absent.uVessel encasement:sometimesVessel encasementpilo

8、cytic astrocytoma）uI级，好发于儿童及青少年.u小脑（80%）、鞍区.u多为囊性或囊实性，实体及附壁 结节强化，囊壁强化.u预后较好.Nodular enhancement pilocytic astrocytomau Pathology Kernohan grades-uIncidence 80%of astrocytomauAge More than 40ys,rare breastmelanomaGI/GU tumorsPath.uRound solid/partially cystic mass+/_edemau IncidenceuMost common site

9、of CNS Mets.from extracrania Tum.u1/4-1/3 of brain tumor.u80%multipleuAge most common in adultsLocationuAnywhere,most commongray-white junctionuImaging multiple,hemorrhage,necrosis.conspicious edema,NECT:iso/hyperdense,CECT:strong solid/ring enhancement MR:most hypointense on T1-,Hyperintense on T2;Most enhance moderatelyMetastatic lung carcinoma 肺癌脑膜转移2-dose contrast-Lung Ca MetsLeft lateral ventricular ependymoma,CSF spreaduGrading of astrocytoma and CT/MR diagnosis?uImaging diagnosis of meningioma?