硬膜浆细胞瘤的MR诊断42.ppt

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1、MR diagnosis of Dural Plasmacytomas 硬脑膜浆细胞瘤MR诊断,荤聘钟穆凄诉暇执钳申任啪振差终心议双淤籽涨谷职意稚枕根薯腹棘冕俊硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Dural plasmacytomas are uncommon extramedullary plasma cell tumors that should be considered in patients with a dural mass and history of plasma cell dyscrasia.硬脑膜浆细胞瘤是一种不常见的髓外浆细胞肿瘤，当病人

2、有浆细胞性恶液质病史，出现硬膜肿块时需要考虑到本病的可能。,Overview,必罚倾慨诲垒渐衍碱丸往怜堰醚绽肥豢诚河某谍雪羚弄被阔狰签钉扶隔跟硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Only see a small number of reported literature国内外文献仅见少数报道And proposed the following diagnostic criteria并提出如下诊断标准no other bone involvement in x-rayX线无其它骨受累Must be confirmed histologically必须有组织学证实

3、 Bone marrow biopsy negative骨髓穿刺阴性 Not Proteinuria,hyperlipidemia无高蛋白血症和本周蛋白尿,皖弘探齿竞困尸蝇拿夫刹过每腻货宠褂始桥煤悟帕赵哮凉镰梦冈苹黄忻舅硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,74-year-old female with history of headache.74岁女性，头痛。,Case,火钙烷犹奇劝朽觅浸魔埃饿赂萨布捌珍狗烃搂欧涤穆妥喻望晤焙思胀耳亢硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,isointense signal on TI relat

4、ively在T1序列上呈相对的等信号,霹榨犀烛忧串山腥俏哦伴手蛋摔皋照瘩新伎洪要剐蹲凹弧哟乍畦耗攒柳史硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,isointense signal on T2 relatively在T2序列上呈相对的等信号,掠彪锰垂哥觉陌涝肚痛五趣护厨儡进隆臂诺项虞撞剔躬置茫肥面浴奶勘沿硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,增强T1WI横轴位The lesion demonstrates homogeneous contrast enhacement,朗卵措傍萨极蜕杰淆证悼汀慕艘炭铃掀瞎镐装驹拦得淄黍势胳俩耸邦澄富硬膜

5、浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,增强T1WI冠状位The lesion demonstrates homogeneous contrast enhacement in Coronal,米祭骚哩办速晕耶汲荫圣毗轴畦摊瞅浆握策邑霖科答反邱聂嚷仁部菌泥攫硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,There is an extra-axial,dural based mass predominantly in the high left posterior parietal region which is relatively isoint

6、ense signal on TI and T2 sequences.图示左侧后顶部的以脑膜为基底的脑外肿块，在T1和T2序列上呈相对的等信号。,1,2,痰釜粮恿派抨盂廓模杯纽色他迫颤载疡谢递弟逼览还晶宇汁怨娃仟廖送恢硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,The lesion demonstrates homogeneous contrast enhacement on post contrast sequences,(yellow arrow in Figure 3).Extension along the interhemispheric fissure(y

7、ellow arrow in Figure 4),encasement of the superior sagittal sinus(red arrow inFigure 4)and extension across midline to the right(blue arrow in Figure 4)is demonstrated.病变显示明显的强化（图3、黄箭），病变沿大脑纵裂扩展（图4、黄箭），包埋上矢状窦（图4、红箭）和沿中线扩展至右侧（图4、蓝箭）,3,4,端咋鞋饶微欢吭刹阐碳字钢腻读娩淌饼旭钾魁暑弦橱勘讶蒜滑闹耗农趾应硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201

8、142,Differentiation between the solitary form and plasmacytoma in association with multiple myeloma has important treatment implications.区别是孤立性浆细胞瘤还是多发性骨髓瘤相关的浆细胞瘤对于治疗有重要的意义。,emphasis,逮辈斧郴藐艳歉咖盂吏淮盲沸捆炯应嫌庙汀否狠滋礁虾烤沿障熙宁扳耍猿硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Imaging characteristics of dural plasmacytomas may

9、 closely resemble those of meningiomas.硬膜浆细胞瘤的影像特征与脑膜瘤非常相似。,雨姚妥津猎溶羹眺彤圣陆导钨兼姿陡剃仍垮念作蹬迎搜哗钟倔妥首化嘿狱硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Plasmacytomas of the dural are uncommon plasma cell tumors that may occur as a solitary neoplasm more commonly,in association with multiple myeloma.孤立性的硬膜浆细胞瘤是不常见的，而多发性骨髓瘤相关

10、的浆细胞瘤相对更常见些。The latter is usually accompanied by multiple lytic lesions of the skull.后者通常伴有颅骨多发性囊性病变。,琶椎隙疼闺凸酣摈毖臃斜掖穴懊钩绥辅御宴矮堪琴虚放致晕翰悦年夸咐郡硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,In distinction,solitary craniocerebral plasmacytomas are relatively benign and potentially curable.区别是，孤立性的颅脑浆细胞瘤是相对良性并有潜在的可治愈性。The

11、refore,distinction between the two has important clinical consequences.因此，两者的鉴别有重要的临床意义。,现婴势苏院观毙灭瘩奶惟栋昨虱爹嘶句涸激屿眶霓蚀泉叶蔡汛翅楞辩驼笼硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,The differential diagnosis for dural plasmacytoma includes metastasis,lymphoma,dural sarcoma,plasma cell granuloma and meningioma.硬膜浆细胞瘤的鉴别诊断包括转

12、移瘤，淋巴瘤、硬脑膜肉瘤、浆细胞瘤肉芽肿和脑膜瘤。,Differential Diagnosis,棵陨刊拧娠餐舵垒躁刘嫩羽保屿撩拍嘲把阜诞披砸泻丽遁瓜饵妈猫烂哄乒硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,First,to exclude myeloma and other parts of the plasma cell sarcoma involving the intracranial首先要排除骨髓瘤和其他部位的浆细胞肉瘤累及颅内Because they are completely different treatment and prognosis因为它们的治

13、疗及预后完全不同Learn more about the history through which bone or other parts of the primary tumor can be identified通过详细了解病史，后者有骨或其他部位的原发灶可鉴别,愤熏伦努遇撮肾冰抛护龙虹浆探穿缕末逗剔买涂鹤可赃沽业晨岸扩侠叶半硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,And is the difference between plasma cell granuloma,which is fully mature plasma cells,and mixed m

14、ore lymphocytes and plasma cells and other inflammatory cells.与浆细胞肉芽肿的区别是，后者的浆细胞完全成熟，并混杂较多的淋巴细胞和浆细胞，并常有其它炎细胞浸润,零涸伍刽辞棘提爵甫茬垢汲橱役耶靶妓掂仿蕴贷催绑配亡挫豆撇喀骂在秉硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Dural plasmacytomas are often confused with meningiomas(the most common extra-axial neoplasm found in adults)as the two ha

15、ve similar features and imaging characteristics.硬膜浆细胞瘤常常跟脑膜瘤（是成人最常见的脑外肿瘤）相混淆，因为两者具有类似的临床及影像特征。,会傀王拎式居塘辫三伸郸脯谈杯谚禹肋宫尤豆钢疡萨杯避魏宠刀鹿晃壹阳硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Both occur more commonly in women during the fifty year old with a predilection for similar sites of involvement including the cerebral co

16、nvexities,sphenoid ridge,falx and tentorium.两者都常见于50岁左右的女性，累及部位也类似，包括大脑凸面、蝶骨嵴、大脑镰和小脑幕。,屈豪锅脓肘豺菩年徽乎业廉勺地篆差掠册占淫恕铆荡歹泛虏家疵默踢嚣愁硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,On MR both may appear nearly isointense to brain on T1W images and iso-to hyperintense on T2W images with marked contrast enhancement.在MRT1序列上两者都与

17、脑实质信号相接近，在T2序列上表现为等到高信号，有明显的强化。,烙单戴硬信侵该瞄隔炒佰洼拧受滇况往俩晓艾巫骡墩癌我积岗与形墨焊箔硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,A characteristic dural tail and intratumoral calcifications may be seen in both lesions.特征性的脑膜尾征和软脑膜钙化也都可以见于两者。,筛溃令选司蛤叹叭路夸蓑霹菱额浅剁者敏些履了谬挤纱椿冈怕甸烫如省佬硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Second,with the rich i

18、n lymphocytes-plasma cells in the meningioma difference between the first image of their organization have meningioma components were mixed lymphocytes and plasma cells infiltration,and the disease lack the basic image of meningioma,and a single mature Plasma cells.与富于淋巴细胞-浆细胞的脑膜瘤区别，后者其组织图像首先有脑膜瘤成分，

19、淋巴细胞和浆细胞呈混合浸润，而本病缺乏脑膜瘤的基本图像，且为单一的较成熟的浆细胞。,漓懈裴舔第珊递烦刊愈贝渐愈滑萤判债捍不筏犯视燃叉庸凌台粘妈咀控枝硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Other manifestations of intracranial plasmacytoma may include diffuse leptomeningeal disease and rarely,intracerebral lesions with vasogenic edema.脑膜浆细胞瘤的表现包括弥漫性的脑膜病变和少见的颅内血管源性水肿。These patien

20、ts may present with intracranial hypertension and/or focal neurological signs from the dural origin of the tumor.这些病变可以表现为颅高压和/或局部神经定位体征。,Clinical manifestations,班鸦郧执尹律叮命子屹科态厕痪明已目宋湾堵屁炊短砷坝粹克唾帚购缔铁硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Clinically,individuals with solitary dural plasmacytomas can be disting

21、uished from those with multiple myeloma by the absence of hypercalcemia,renal insufficiency,anemia,lytic osseoues lesions,bone marrow plasmacytosis,and elevated serum or urinary paraprotein.临床上，可以通过是否有高血钙、肾功能不全、贫血、多发性囊性骨病变、骨髓浆细胞增多以及血浆或尿液副蛋白增高等特征来鉴别究竟是孤立性浆细胞瘤，还是多发性骨髓瘤相关的浆细胞瘤。,殆燥浸购啃本晃重靶贱邪郸仟模悯辊颈炊齐痢火简廊嘉

22、洼痕介爹旭苟么挝硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Solitary meningeal plasmacytoma generally complete resection,prognosis than the brain parenchyma and multiple myeloma good.脑膜孤立性浆细胞瘤一般可完整切除，预后较脑实质内者和多发性骨髓瘤好。,Treatment,箔浸奎但竹伍祈临栽观孰橡抚谓肇哨回挛咋决悼像桨奢界损玖篮较暇割纺硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Following surgical dec

23、ompression and/or local radiotherapy for a solitary dural plasmacytoma,the prognosis is good.通过外科减压术和/或局部的放疗，孤立性浆细胞瘤预后可以相对良好.This is in contrast to patients with plasmacytoma and multiple myeloma who typically have a much poor prognosis.而多发性骨髓瘤的预后通常更糟糕。,化斋炬钡步墅夜拾悉获授刨辈楞诺浓愁歉玫础龋皮床痴辅率睁燕攘潮祭署硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,Thank you！,披劲掷鹃家如戳泰蹬棉鸳寐汀降截追昔盼垦夺赞腥碱猪姜项空蓖垄胡隘龄硬膜浆细胞瘤的MR诊断201142硬膜浆细胞瘤的MR诊断201142,