影像所见
CT
- 以第四脑室为中心的高密度后颅窝肿块
- 梗阻性脑积水伴侧脑室和第三脑室明显扩张及脑室周围水肿
- 弥漫性脑沟和脑池消失
MRI
- 起源于第四脑室底部的大型不均匀强化肿块，通过右侧大于左侧Luschka孔及Magendie孔延伸至桥前池、延髓前池和上颈段椎管
- 对小脑、桥脑、延髓和上颈段脊髓产生广泛占位效应
- T2信号强度与灰质相似
- 无弥散受限
- 与CT相关的少数内部磁敏感伪影灶可能代表钙化
- 包绕基底动脉和硬膜内椎动脉
带注释的图像和插图
Posterior fossa ependymoma extending through the foramina of Luschka (red arrows), encasing the basilar artery (yellow arrow), and severely deforming the medulla (blue arrow).
Sagittal T1 precontrast image shows the tumor encasing multiple posterior fossa structures and extending inferiorly within the dorsal aspect of the upper cervical spinal canal (red arrow).
Heterogeneous areas of internal enhancement, including in the prepontine tumor component (red arrow).
诊断
室管膜瘤
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