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1、 中樞神經(jīng)系統(tǒng)腫瘤影像診斷 The 2007 WHO Classification of Tumours of the Central Nervous System1、神經(jīng)上皮組織起源腫瘤神經(jīng)上皮組織起源腫瘤（Tumours of neuroepithelial tissue）u星形細(xì)胞腫瘤星形細(xì)胞腫瘤(Astrocytic tumors)u少突膠質(zhì)細(xì)胞腫瘤少突膠質(zhì)細(xì)胞腫瘤（Oligodendroglial tumours）u少突星形細(xì)胞腫瘤少突星形細(xì)胞腫瘤（Oligoastrocytic tumours）u室管膜腫瘤室管膜腫瘤（Ependymal tumours）u脈絡(luò)叢腫瘤脈絡(luò)叢腫瘤（Ch

2、oroid plexus tumours）u其它神經(jīng)上皮類腫瘤其它神經(jīng)上皮類腫瘤（Other neuroepithelial tumours）u神經(jīng)元和混合性神經(jīng)元神經(jīng)元和混合性神經(jīng)元-神經(jīng)膠質(zhì)腫瘤神經(jīng)膠質(zhì)腫瘤 （Neuronal and mixed neutonal-glial tumours）u松果體區(qū)腫瘤松果體區(qū)腫瘤（Tumourl of the pineal region）u胚胎類腫瘤胚胎類腫瘤（Embryonal tumours）2、顱腦和脊神經(jīng)起源腫瘤顱腦和脊神經(jīng)起源腫瘤（Tumours of cranial and paraspinal nervesTumours of cran

3、ial and paraspinal nerves）u許旺氏細(xì)胞瘤（神經(jīng)鞘膜瘤，神經(jīng)鞘瘤)（Schwannoma(neurilemoma,neurinoma)u神經(jīng)纖維瘤（Neurofibroma)u神經(jīng)束膜瘤 （Perineurioma）u惡性周圍神經(jīng)鞘瘤 (Malignant peripheral nerve sheath tumour，MPNST)3、腦（脊）膜起源腫瘤腦（脊）膜起源腫瘤（Tumours of the meninges）u腦脊膜上皮細(xì)胞腫瘤腦脊膜上皮細(xì)胞腫瘤（Tumours of meningothelial cells）Meningiomau腦膜間質(zhì)腫瘤腦膜間質(zhì)腫瘤(M

4、esenchymal tumours)u原發(fā)性黑色素細(xì)胞病變?cè)l(fā)性黑色素細(xì)胞病變（Primary melanocytic lesions）u與腦膜相關(guān)的其他類腫瘤與腦膜相關(guān)的其他類腫瘤（Other neoplasms related to the meninges）4、淋巴瘤和造血系統(tǒng)起源腫瘤、淋巴瘤和造血系統(tǒng)起源腫瘤(Lymphomas and haematopoietic neoplasm)Lymphomas and haematopoietic neoplasm)u惡性淋巴瘤（Malignant lymphomas）u漿細(xì)胞瘤（Plasmacytoma）u粒細(xì)胞肉瘤（Granulocyt

5、ic sarcoma）5、生殖細(xì)胞起源腫瘤、生殖細(xì)胞起源腫瘤（Germ cell tumours）u生殖細(xì)胞瘤（Germinoma）u胚胎性癌（Embryonal carcinoma）u卵黃囊性瘤（Yolk sac tumour）u絨毛膜癌（Choriocarcinoma）u畸胎瘤（Teratoma）u混合性生殖細(xì)胞腫瘤（Mixed germ cell tumour）6、鞍區(qū)腫瘤、鞍區(qū)腫瘤（Tumours of the sellar region）u顱咽管瘤(Craniopharyngioma)u顆粒細(xì)胞瘤（Granular cell tumour）u垂體細(xì)胞瘤（Pituicytoma）*u腺

6、垂體梭形細(xì)胞嗜酸性細(xì)胞瘤*（Spindle cell oncocytoma of the adenohypophysis）7、轉(zhuǎn)移性腫瘤、轉(zhuǎn)移性腫瘤（Metastatic tumours）星形細(xì)胞瘤（星形細(xì)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)Astrocytom

7、au Circumscribed Astrocytoma(benign,I)u Grade II Astrocytomau Anaplastic(Malignant)astrocytoma(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 an

8、d young adults(2040ys)uLocation Cerebral hemispheres,cerebellum,brain stem.CT/MRI：uNECT:Focal/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 a

9、nd mass effect usually minimal or absent.uVessel encasement:sometimesVessel encasement毛細(xì)胞性星形細(xì)胞瘤（pilocytic astrocytoma）uI級(jí)，好發(fā)于兒童及青少年.u小腦（80%）、鞍區(qū).u多為囊性或囊實(shí)性，實(shí)體及附壁 結(jié)節(jié)強(qiáng)化，囊壁強(qiáng)化.u預(yù)后較好.Nodular enhancement pilocytic astrocytomaHigh-grade astrocytomau Pathology Kernohan grades-uIncidence 80%of astrocytomauAge

10、More than 40ys,rare breastmelanomaGI/GU tumorsPath.uRound solid/partially cystic mass+/_edemau IncidenceuMost common site 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,necros

11、is.conspicious edema,NECT:iso/hyperdense,CECT:strong solid/ring enhancement MR:most hypointense on T1-,Hyperintense on T2;Most enhance moderatelyMetastatic lung carcinoma 肺癌腦膜轉(zhuǎn)移2-dose contrast-Lung Ca MetsLeft lateral ventricular ependymoma,CSF spreadREVIEWuGrading of astrocytoma and CT/MR diagnosis?uImaging diagnosis of meningioma?