Cerebellar vermis tumor symptoms?
summary
Cerebellum is the most common area of intracranial tumors, which can occur in both adults and children. The common tumors are astrocytoma, medulloblastoma, hemangioblastoma, ependymoma and so on. The malignant degree of these four kinds of tumors is different, so the treatment and prognosis are also different. Therefore, the normal preoperative diagnosis is of great clinical significance for the formulation of treatment plan and the judgment of prognosis. Cerebellar vermis tumor symptoms? Let's talk about it.
Cerebellar vermis tumor symptoms?
1. Astrocytoma is a tumor with specific morphological changes and biological behavior transformed from astrocytes. It mainly occurs in children. The peak age is before 10 years old. A few tumors can occur in adults, but most of them are young people. Cerebellar astrocytoma can be divided into three types: cystic, partially cystic and parenchymal, but most of them are the former two. The fluid in the capsule is viscous, the wall of the capsule is composed of glial components, and some wall nodules can be seen in the capsule. CT plain scan showed that the solid component density of the tumor was equal to or lower than that of the normal white matter, and the enhancement was uneven; When the cystic tumor had mural nodules, the nodules were enhanced homogeneously. The solid part of Mr T1WI showed low signal, T2WI and flair showed high signal, and the enhancement was uneven.
2. Medulloblastoma is derived from medulloblastoma, which is similar to the second generation of primordial small cells of embryonic medullary epithelium. It has the characteristics of two-way differentiation, both to nerve cells and to glial cells. Children are more common in cerebellar vermis, adults are more common in cerebellar surface. It mainly occurs before the age of 15, and is most common between the age of 4-8. The other peak age is around 25. Medulloblastoma is mostly solid, round or irregular, with clear boundary, cystic changes, rare bleeding and calcification. On MRI plain scan, both T1WI and T2WI tend to be isointense, T1WI slightly low or isointense, T2WI slightly high or isointense, DWI high signal and ADC low signal are the characteristic manifestations of medulloblastoma. The enhancement pattern and degree of medulloblastoma are related to the pathological classification of medulloblastoma. It is considered that the classic type is mostly mild enhancement or marginal linear enhancement, while the other subtypes include fibroproliferative / nodular type, medulloblastoma with extensive nodules, fibrogenic / nodular type The enhancement pattern of anaplastic and large cell medulloblastoma was obvious.
3. Hemangioblastoma is mainly composed of vascular endothelial cells, pericytes and stromal cells. It is generally believed that the tumor originated from the mesoderm cells in the early embryonic stage, and the residual embryonic cells formed benign tumor during the formation of primitive blood vessels. It mainly occurred in the cerebellar hemisphere and vermis of adults. Hemangioblastoma can be seen at any age, but mostly in 30-40 years old. It is the most common tumor in the fourth ventricle of cerebellum in adults. The typical manifestation is cystic cavity nodule type, which is large cyst and small nodule. The tension of cystic cavity is high. The tumor nodule is single. There is a separation in the cystic cavity. A large amount of bleeding in the cyst is occasionally seen. Simple cyst type and solid mass type are rare. Cystic nodular type: because the cystic fluid contains protein components, the CT value of cystic fluid is slightly higher, the T1WI signal is slightly higher than that of cerebrospinal fluid, and the flair signal is slightly higher or high, which is obviously different from other cystic lesions. The wall of the capsule is composed of collagen fibers, most of which are not enhanced. When there is glial hyperplasia or tumor tissue around the tumor, the enhancement can occur. Some of the lesions showed empty blood vessels, most of which were large cysts and nodules.
matters needing attention
CT and MRI showed an expansive mass in one side of the cerebellum with parallel stripes or tiger stripes. On CT, the lesion was low density and could be accompanied by calcification. The lesions showed low signal on T1WI, high signal on T2WI, no perifocal edema, no enhancement on enhanced scan, and could compress the fourth ventricle and midbrain aqueduct, causing obstructive hydrocephalus. Striated lesions are characteristic features of dysplastic gangliocytoma of cerebellum.
