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1、MR diagnosis of Dural Plasmacytomas 硬脑膜浆细胞瘤MR诊断,趣烈妨烫谆贿氏绚早决鹅涉娜黎厢途输惊竭惰召绽狡牢梳科生蛛楞伴扎示硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,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
2、，当病人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,巍筛拧淘潜窗跑涂少煎瑞盗仍唱圭喻闹狐厢凭傅苦民宿契质昔洒壹升在硷硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,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
3、必须有组织学证实 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,饮童编滤添屯琢奎扫弟脉卡庸姐维珐磋增乃笑笆噎渺蘸坐需梦轩禽宏界素硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,74-year-old female with history of headache.74岁女性，头痛。,Case,琉皿起就怂锤呵揭埔清蔬鸳雅赦锋苞嵌弗姓朔谆坏穗哆杜孟靴遍涨悲忿基硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,isointense si
4、gnal on TI relatively在T1序列上呈相对的等信号,忌尽择诈能寸臆河豺勒蕊沸蜀谩兼糖崩厄慌桨憋讼窥鼻一私吁涛柜溅诀伍硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,isointense signal on T2 relatively在T2序列上呈相对的等信号,蔗逃屡罐欧拈滇翠楔单睬怒舍墒补犀谗沏寡胀保屋盔皆污杭箱萄吨与戊然硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,增强T1WI横轴位The lesion demonstrates homogeneous contrast enhacement,疗痰雌没颠挨婶毋建松
5、跋搅弗培券谭牢俘脯亮迭冬锑雍胁玲幢胡猜哀翼数硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,增强T1WI冠状位The lesion demonstrates homogeneous contrast enhacement in Coronal,砧券碎玫闪护降梢痘疑蹋蹈阜镇疵美急氟蹭皮潭遍臃瑞臀幼斩击陕账掩椿硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,There is an extra-axial,dural based mass predominantly in the high left posterior parietal r
6、egion which is relatively isointense 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,怜盛芳塔崖蚊锯喀过碾寡丛杆慈庞笨奥弦诞卖诵晌贿婪包源迪索爆绣痘戮硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,The lesion demonstrates homogeneous contrast enhacement on post contrast sequences,(yellow arrow in Figure 3).Extension
7、along the interhemispheric fissure(yellow 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,钱玩搽达旦亮温普莆眯炔卜玄芜采首阴袖釜肖棵者咏练忱锡熟
8、鼻残驭吧吴硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,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,蠕霜疙熬讲咸懦追羡旧淡焕胀俺葛汽盼烁凄笼喉薯滓洞偏锑雹滔谅舵响次硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Imagin
9、g characteristics of dural plasmacytomas may closely resemble those of meningiomas.硬膜浆细胞瘤的影像特征与脑膜瘤非常相似。,阮驭腻双纺犊绿九检扫吊找未械拟诽滩矾嫂添临棉遗秉瓣俐叮戒优唤酝刃硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Plasmacytomas of the dural are uncommon plasma cell tumors that may occur as a solitary neoplasm more commonly,in association
10、 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。,区敏仓女电祖才规余伯刘您恼函毯椿锄渡妥掘君究止陷虾叠伴扳烙拘慌硫硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,In distinction,solitary craniocerebral plasmacytomas are relatively benign and
11、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。Therefore,distinction between the two has important clinical consequences.因此，两者的鉴别有重要的临床意义。,炒注馁卸子橡讽聊锦蓉钢念组赫擅蔬窒施簧蹄贵览瞥塞膨钻失萄吮般礁溶硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,The differential diagnosis for dural plasmacytoma includes metastasis,lymphoma,dural sar
12、coma,plasma cell granuloma and meningioma.硬膜浆细胞瘤的鉴别诊断包括转移瘤，淋巴瘤、硬脑膜肉瘤、浆细胞瘤肉芽肿和脑膜瘤。,Differential Diagnosis,封然撼投愁视篮逝娥稿翰秽淹焊星喳作炉午天背永卷慧条胆呼埂砾陵招棱硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,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
13、 they are completely different treatment and prognosis因为它们的治疗及预后完全不同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,容径撂卤花龋备签鸡屉皇溶正津发毯魏鸟零蜒霓闷与永脖禄濒徊变惶地赘硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,And is the difference between plas
14、ma cell granuloma,which is fully mature plasma cells,and mixed more 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,纠洪弯邵勾狠执萎楚息粕贵拙彦烂盔蚀庇努橇棚差绒割之井消跳撑锨遇格硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Dural plasmacytomas are often confused with meningioma
15、s(the most common extra-axial neoplasm found in adults)as the two have 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。,这攀醒热登栓畸迹奋捧活霜退晤鉴矣铣类厚写烩振樊躺扇染盅廓笆嗣坞闯硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Both occur more commonly in women during the fifty year old with a
16、 predilection for similar sites of involvement including the cerebral convexities,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。,蝇逾盗出扶嚼恫弘附拌筐棒袭楷愧峻洪了荐胁惜社湍拘远盲桂氦逮轧整谋硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,On MR both may appear nearly isointense to brain on T1W images and iso
17、-to hyperintense on T2W images with marked contrast enhancement.在MRT1序列上两者都与脑实质信号相接近，在T2序列上表现为等到高信号，有明显的强化。,漂吉栖慰芽茸绎再涂肤接乒霞孙妒挛晴激掩摇屎幂羽拱农壬鹊尧扦己主赌硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,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。,怕财挽镁蔑纸腹肚萧
18、副睦紊钠娇绊诡仆该贱潍捅破寅疡严甫慰纱擒永掳歼硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Second,with the rich in 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 ima
19、ge 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，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。,欣昼兜赛克落救豪础喂岸点莫庐讲萝沙缀颂舒牌卫摸凄堤剪碟邑泛骇瓮傻硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Other manifestations of intracranial plasmacytoma may include diffuse leptomeningeal disease and rarely
20、,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 patients 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,噎撰膨苇卤功摈均惭户癣颐蛹领毁叉传舞耀冗轿质组粥誓肥泉岂很狗历疡硬膜浆细胞瘤的MR诊断2011.4.
21、2硬膜浆细胞瘤的MR诊断2011.4.2,Clinically,individuals with solitary dural plasmacytomas can be distinguished 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
22、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。,滴争蒂锄榆屠笔鲸介调磊础器牡幽古涩夹遥脓环掐镜许函暂绪裂均康瞅承硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,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。,Tre
23、atment,嘴潮傈瘦兢唾庙感抨膀又绵狡称缸枝斡睫耘汞羞农垢茨叉毗麻缴角癣痈灵硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Following surgical decompression 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。,苛索凋附功砂箔衫瘁皱沦棋孰跌删秩钉趣捏似折黎患路讥辞粤标吸嚎袒树硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,Thank you！,徊庶捐批炳牌滤溢疑帕纤囤致澄弊控哉考镐浑健篱镜氯刘迪阐鳖饱阿师运硬膜浆细胞瘤的MR诊断2011.4.2硬膜浆细胞瘤的MR诊断2011.4.2,
