1、.,1,Case report Xian central hospital Dang shan,.,2,New words,somnolentia smnlenr 嗜睡 morphology m:rf:ldi 形態(tài)學(xué) paediatric pi:dtrk 兒科的 hydrocephalushadrsefls 腦積水 heterogeneous 成分混雜的 cauliflower 菜花 neuroepithelial 神經(jīng)上皮的 prognosis 預(yù)后 infiltrate 浸潤(rùn) 滲透,.,3,Medical history,2-year-old male patient Somnolenti

2、a,decrease consciousness 3 hours,.,4,.,5,.,6,.,7,.,8,.,9,.,10,.,11,.,12,A Ependymoma B Choroid plexus papilloma C Intraventricular meningioma D Glioblastoma,What is your diagnosis?,.,13,Pathological result,Lateral ventricle glioblastoma Immunohistochemistry:GFAP +、S-100 +、Vim +、Syn part+、Ki67 40%、Ol

3、ig-2 few、CD99 -/+、NeuN -CK -、EMA -,.,14,Glioblastoma,Incidence：Glioblastoma accounts for about 57% of all brain tumors in children Peak age：4555 years old less occur at age lower than 30-year-old Location:Supratentorial white matter most common,especially in frontal and temporal lobes.,.,15,Morpholo

4、gy:Poorly-marginated ,diffusely-infiltrating necrotic mass. Tumor typically acrosses white matter tracts to involve contralateral hemisphere Prognosis:Poor,1year survival rate is only about 50%,.,16,NECT Finding：Irregular isodense or hypodense mass with central hypodensity representing necrosis. Mar

5、ked mass effect and surrouding edema ,tumor infiltration，hemorrage not uncommon，calcification rare CECT Finding：95%have stong,heterogeneous,irregular rim-enhancement,.,17,T1WI irregular isotense , hypointense white matter mass T2WI heterogeneous,hypointense mass with adjacent tumor infiltration and

6、edema DWI no typically diffusion restriction necrosis,cysts,hemorrage may be seen,MR Finding,.,18,Ependymoma,Peak age:before the age of 5 years old Location: about 8% occured in the lateral ventricle Morphology：typically heterogeneous mass ,with areas of necrosis, calcification, cystic change and fr

7、equent hemorrhage MR Finding： T1WI isointense to hypointense relative to white matter T2WI hyperintense to white matter T1C+ (Gd) enhancement present but heterogeneous DWI diffusion restrict may be seen in solid components,.,19,CT Ependymoma,.,20,MR Ependymoma,.,21,An uncommon, benign neuroepithelia

8、l intraventricular tumour which can occur in both the paediatric and adult . lobulated or cauliflower-like masses hydrocephalus common CT iso- or somewhat hyperdense， homogeneous enhancement T1WI typically isointense or somewhat hypointense T2WI iso to hyperintense T1 C+ (Gd) marked enhancement, ten

9、ds to be homogenous,Choroid plexus papilloma,.,22,T2WI T1WI,.,23,T1C+ Choroid plexus papilloma,.,24,Intraventricular meningioma, Location:80% trigone of lateral ventricle,15% the third ventricle, 5% the fourth ventricle CT 60%slightly hyperdense to normal brain,20- 30% have some calcification,72% brightly and homogenously contrast enhance,less frequent in malignant or cystic variants T1WI isointense or somewhat hypointense compared to grey matter T2WI isointense, hyperintense or h