【摘要】 目的:探讨成人小脑髓母细胞瘤的MRI表现及神经元特异性烯醇化酶(Neuron-Specific Enolase,NSE)特点。方法:对17例经手术病理证实的成人小脑髓母细胞瘤的MR表现进行分析。免疫组化法检测肿瘤组织中NSE表达。ELISA试剂盒检测血清NSE水平。结果 :髓母细胞瘤均位于小脑半球,其中右侧11例,左侧6例,部分累及小脑蚓部,肿瘤形状多不规则,小脑皮髓质同时受累,实质部分多分布性,10例为男性,发病年龄最大者为64岁。肿瘤实性部分与小脑灰质比较,T1WI为略低信号,T2WI为等或稍高信号。髓母NSE表达水平和强度显著高于正常人脑组织细胞瘤(P<0.01),17例髓母细胞瘤中NSE大部分呈强阳性表达。病理学显示光学显微镜下组织是原始的、未分化的肿瘤细胞,核梭形,形成许多菊形团瘤细胞。部分组织体积较小,向髓母细胞分化。局部分化为神经节细胞。结论:成人小脑髓母细胞瘤的MRI表现有一定的特征性,能够与其他小脑肿瘤相鉴别。NSE可作为小脑髓母细胞瘤的神经损伤指标。更多还原

【Abstract】 Objective To discuss the MR findings and the changes of neuron-specific enolase(NSE) in adult cerebellar medulloblastoma. Methods The MR findings of 17 patients with cerebellar medulloblastoma in adults confirmed by operation and pathology were retrospectively analyzed. The expression of neuron-specific enolase(NSE) was observed by immunohistochemistry,and the NSE levels of serum in patients with medulloblastoma were detected by Elisa Kit. Results All medulloblastomata are located in the cerebellar hemisphere, including 11 cases on the right side, 6 cases left. The cerebellar vermes are partially involved and the tumor shapes are irregular. Cerebellar cortices and medullas are involved at the same time, and most of the substantial parts are distributed. 10 cases of male and the eldest age is 64 y. Most substantial tumors showed slightly low signal intensity on T1 WI and isointensity or slightly high signal intensity on T2 WI, compared with normal gray matters of the cerebellum. The expression levels of NSE in medulloblastomas group were significantly higher than those in normal human brain tissues(P<0.01).NSE of Medulloblastoma in 17 cases showed the strongly positive expression and the positive expression rate was strongly positive(+ + + +). Pathology showed that the tissues were original and undifferentiated tumor cells and the nuclear spindle cells,forming many chrysanthemum mass of tumor cells under optical microscope. Some of the tissues were smaller, turning to the marrow cell differentiation. Local differentiation was for the ganglion cells. Conclusion Adult Cerebellar medulloblastomata have some MR manifestation, which can be discriminated from other cerebellar tumor by analysis. NSE can be a marker of neurological injury in medulloblastomata.更多还原