顱腦腫瘤診斷思路課件

顱腦腫瘤診斷思路顱腦腫瘤診斷思路1顱腦占位性病變腦實(shí)質(zhì)內(nèi)占位垂體和鞍區(qū)占位腦實(shí)質(zhì)外占位顱腦占位性病變腦實(shí)質(zhì)內(nèi)占位垂體和鞍區(qū)占位腦實(shí)質(zhì)外占位2腦實(shí)質(zhì)內(nèi)占位幕上腫瘤腦室內(nèi)腫瘤松果體腫瘤幕下腫瘤低度惡性膠質(zhì)瘤間變膠質(zhì)瘤膠質(zhì)母細(xì)胞瘤轉(zhuǎn)移瘤淋巴瘤腦干膠質(zhì)瘤小腦星形細(xì)胞瘤髓母細(xì)胞瘤室管膜瘤血管母細(xì)胞瘤生殖細(xì)胞瘤精原細(xì)胞瘤畸胎瘤脈絡(luò)叢乳頭狀瘤腦膜瘤室管膜瘤轉(zhuǎn)移瘤淋巴瘤腦實(shí)質(zhì)內(nèi)占位幕上腫瘤腦室內(nèi)腫瘤松果體腫瘤幕下腫瘤低度惡性膠質(zhì)3垂體和鞍區(qū)占位腫瘤非腫瘤性病變垂體腺瘤腦膜瘤膠質(zhì)瘤動(dòng)脈瘤Rathke囊腫空蝶鞍蛛網(wǎng)膜囊腫皮樣囊腫表皮樣囊腫顱咽管瘤轉(zhuǎn)移瘤垂體和鞍區(qū)占位腫瘤非腫瘤性病變垂體腺瘤腦膜瘤膠質(zhì)瘤動(dòng)脈瘤R4“六瘤四囊腫空蝶鞍”：垂體瘤、顱咽管瘤、腦膜瘤、動(dòng)脈瘤、膠質(zhì)瘤、轉(zhuǎn)移瘤（前四者八年制課本有鑒別表，前五者有概述）；RATHKE囊腫，蛛網(wǎng)膜囊腫，皮樣囊腫，表皮樣囊腫；口訣：垂體瘤、顱咽管瘤，腦膜動(dòng)脈，膠質(zhì)轉(zhuǎn)移瘤。-----------------------------------------------------------------------------------------鞍內(nèi)：垂體瘤、顱咽管瘤、腦膜瘤、囊腫、增生鞍上：垂體瘤、顱咽管瘤、腦膜瘤、動(dòng)脈瘤、膠質(zhì)瘤、轉(zhuǎn)移瘤（成人鞍上：垂體瘤、腦膜瘤、動(dòng)脈瘤、轉(zhuǎn)移瘤、淋巴瘤、皮樣囊腫、表皮樣囊腫）（兒童鞍上：顱咽管瘤、膠質(zhì)瘤、生殖細(xì)胞瘤、蛛網(wǎng)膜囊腫、灰結(jié)節(jié)錯(cuò)構(gòu)瘤）-----------------------------------------------------------------------------------------鞍區(qū)常見(jiàn)囊性病變：蛛網(wǎng)膜囊腫、表皮樣囊腫、Rathke囊腫、顱咽管瘤、第三腦室擴(kuò)張、垂體膿腫。-----------------------------------------------------------------------------------------鞍區(qū)常見(jiàn)病變（T1高信號(hào)）：異位神經(jīng)垂體、脂肪瘤、皮樣囊腫、栓塞性動(dòng)脈瘤“六瘤四囊腫空蝶鞍”：垂體瘤、顱咽管瘤、腦膜瘤、動(dòng)脈瘤、膠質(zhì)5腦實(shí)質(zhì)外占位腦膜瘤頸靜脈球瘤淋巴瘤脂肪瘤脈絡(luò)叢乳頭狀瘤脊索瘤轉(zhuǎn)移瘤顱骨腫瘤，包括斜坡的軟骨瘤和軟骨肉瘤聽(tīng)神經(jīng)瘤三叉神經(jīng)瘤腦實(shí)質(zhì)外占位腦膜瘤頸靜脈球瘤淋巴瘤脂肪瘤脈絡(luò)叢乳頭狀瘤脊索瘤6腦內(nèi)占位性病變囊性含氣腫塊囊實(shí)性實(shí)性腫瘤、蛛網(wǎng)膜囊腫、腦囊蟲(chóng)、腦膿腫、血腫腫瘤、膿腫早期、結(jié)核球、脫髓鞘斑塊腫瘤壞死囊變、腦膿腫、寄生蟲(chóng)病，如腦囊蟲(chóng)等，皮樣囊腫、血管母細(xì)胞瘤開(kāi)放性顱腦損傷積血積氣腫塊、炎癥、膿腫腫瘤壞死合并感染腦內(nèi)占位性病變囊性含氣腫塊囊實(shí)性實(shí)性腫瘤、蛛網(wǎng)膜囊腫、腫瘤、7顱內(nèi)腫瘤神經(jīng)膠質(zhì)瘤星形膠質(zhì)細(xì)胞瘤少突膠質(zhì)細(xì)胞瘤腦膜瘤生殖細(xì)胞瘤轉(zhuǎn)移性腫瘤鞍區(qū)及其周?chē)某Ｒ?jiàn)腫瘤垂體瘤顱咽管瘤橋小腦角區(qū)的常見(jiàn)腫瘤聽(tīng)神經(jīng)瘤膽脂瘤后顱窩的常見(jiàn)腫瘤血管網(wǎng)織細(xì)胞瘤髓母細(xì)胞瘤摘自大三實(shí)習(xí)課件顱內(nèi)腫瘤神經(jīng)膠質(zhì)瘤摘自大三實(shí)習(xí)課件8根據(jù)病灶起源的解剖結(jié)構(gòu)，對(duì)鞍區(qū)的病變進(jìn)行歸類(lèi)分析：

1、垂體腺：垂體腺瘤、Rathke’s囊腫、顱咽管瘤2、垂體柄：Rathke’s囊腫、顱咽管瘤、生殖細(xì)胞瘤、嗜酸性肉芽腫、轉(zhuǎn)移瘤3、視交叉：神經(jīng)膠質(zhì)瘤、脫髓鞘病變4、下丘腦：膠質(zhì)瘤、錯(cuò)構(gòu)瘤、生殖細(xì)胞瘤、嗜酸性肉芽腫5、腦膜：腦膜瘤、轉(zhuǎn)移瘤、感染性病變（結(jié)核性腦膜炎、結(jié)節(jié)?。?、蝶竇/顱底骨（斜坡）：鱗狀細(xì)胞癌、脊索瘤、肉瘤、轉(zhuǎn)移瘤、炎癥7、海綿竇：CCF、神經(jīng)鞘瘤、海綿竇血栓性靜脈炎8、血管（頸內(nèi)動(dòng)脈）：動(dòng)脈瘤根據(jù)病灶起源的解剖結(jié)構(gòu)，對(duì)鞍區(qū)的病變進(jìn)行歸類(lèi)分析：9顱腦腫瘤診斷思路課件10顱腦腫瘤診斷思路課件11顱腦腫瘤診斷思路課件12顱腦腫瘤診斷思路課件13顱腦腫瘤診斷思路課件14顱腦腫瘤診斷思路課件15顱腦腫瘤診斷思路課件16顱腦腫瘤診斷思路顱腦腫瘤診斷思路17顱腦占位性病變腦實(shí)質(zhì)內(nèi)占位垂體和鞍區(qū)占位腦實(shí)質(zhì)外占位顱腦占位性病變腦實(shí)質(zhì)內(nèi)占位垂體和鞍區(qū)占位腦實(shí)質(zhì)外占位18腦實(shí)質(zhì)內(nèi)占位幕上腫瘤腦室內(nèi)腫瘤松果體腫瘤幕下腫瘤低度惡性膠質(zhì)瘤間變膠質(zhì)瘤膠質(zhì)母細(xì)胞瘤轉(zhuǎn)移瘤淋巴瘤腦干膠質(zhì)瘤小腦星形細(xì)胞瘤髓母細(xì)胞瘤室管膜瘤血管母細(xì)胞瘤生殖細(xì)胞瘤精原細(xì)胞瘤畸胎瘤脈絡(luò)叢乳頭狀瘤腦膜瘤室管膜瘤轉(zhuǎn)移瘤淋巴瘤腦實(shí)質(zhì)內(nèi)占位幕上腫瘤腦室內(nèi)腫瘤松果體腫瘤幕下腫瘤低度惡性膠質(zhì)19垂體和鞍區(qū)占位腫瘤非腫瘤性病變垂體腺瘤腦膜瘤膠質(zhì)瘤動(dòng)脈瘤Rathke囊腫空蝶鞍蛛網(wǎng)膜囊腫皮樣囊腫表皮樣囊腫顱咽管瘤轉(zhuǎn)移瘤垂體和鞍區(qū)占位腫瘤非腫瘤性病變垂體腺瘤腦膜瘤膠質(zhì)瘤動(dòng)脈瘤R20“六瘤四囊腫空蝶鞍”：垂體瘤、顱咽管瘤、腦膜瘤、動(dòng)脈瘤、膠質(zhì)瘤、轉(zhuǎn)移瘤（前四者八年制課本有鑒別表，前五者有概述）；RATHKE囊腫，蛛網(wǎng)膜囊腫，皮樣囊腫，表皮樣囊腫；口訣：垂體瘤、顱咽管瘤，腦膜動(dòng)脈，膠質(zhì)轉(zhuǎn)移瘤。-----------------------------------------------------------------------------------------鞍內(nèi)：垂體瘤、顱咽管瘤、腦膜瘤、囊腫、增生鞍上：垂體瘤、顱咽管瘤、腦膜瘤、動(dòng)脈瘤、膠質(zhì)瘤、轉(zhuǎn)移瘤（成人鞍上：垂體瘤、腦膜瘤、動(dòng)脈瘤、轉(zhuǎn)移瘤、淋巴瘤、皮樣囊腫、表皮樣囊腫）（兒童鞍上：顱咽管瘤、膠質(zhì)瘤、生殖細(xì)胞瘤、蛛網(wǎng)膜囊腫、灰結(jié)節(jié)錯(cuò)構(gòu)瘤）-----------------------------------------------------------------------------------------鞍區(qū)常見(jiàn)囊性病變：蛛網(wǎng)膜囊腫、表皮樣囊腫、Rathke囊腫、顱咽管瘤、第三腦室擴(kuò)張、垂體膿腫。-----------------------------------------------------------------------------------------鞍區(qū)常見(jiàn)病變（T1高信號(hào)）：異位神經(jīng)垂體、脂肪瘤、皮樣囊腫、栓塞性動(dòng)脈瘤“六瘤四囊腫空蝶鞍”：垂體瘤、顱咽管瘤、腦膜瘤、動(dòng)脈瘤、膠質(zhì)21腦實(shí)質(zhì)外占位腦膜瘤頸靜脈球瘤淋巴瘤脂肪瘤脈絡(luò)叢乳頭狀瘤脊索瘤轉(zhuǎn)移瘤顱骨腫瘤，包括斜坡的軟骨瘤和軟骨肉瘤聽(tīng)神經(jīng)瘤三叉神經(jīng)瘤腦實(shí)質(zhì)外占位腦膜瘤頸靜脈球瘤淋巴瘤脂肪瘤脈絡(luò)叢乳頭狀瘤脊索瘤22腦內(nèi)占位性病變囊性含氣腫塊囊實(shí)性實(shí)性腫瘤、蛛網(wǎng)膜囊腫、腦囊蟲(chóng)、腦膿腫、血腫腫瘤、膿腫早期、結(jié)核球、脫髓鞘斑塊腫瘤壞死囊變、腦膿腫、寄生蟲(chóng)病，如腦囊蟲(chóng)等，皮樣囊腫、血管母細(xì)胞瘤開(kāi)放性顱腦損傷積血積氣腫塊、炎癥、膿腫腫瘤壞死合并感染腦內(nèi)占位性病變囊性含氣腫塊囊實(shí)性實(shí)性腫瘤、蛛網(wǎng)膜囊腫、腫瘤、23顱內(nèi)腫瘤神經(jīng)膠質(zhì)瘤星形膠質(zhì)細(xì)胞瘤少突膠質(zhì)細(xì)胞瘤腦膜瘤生殖細(xì)胞瘤轉(zhuǎn)移性腫瘤鞍區(qū)及其周?chē)某Ｒ?jiàn)腫瘤垂體瘤顱咽管瘤橋小腦角區(qū)的常見(jiàn)腫瘤聽(tīng)神經(jīng)瘤膽脂瘤后顱窩的常見(jiàn)腫瘤血管網(wǎng)織細(xì)胞瘤髓母細(xì)胞瘤摘自大三實(shí)習(xí)課件顱內(nèi)腫瘤神經(jīng)膠質(zhì)瘤摘自大三實(shí)習(xí)課件24根據(jù)病灶起源的解剖結(jié)構(gòu)，對(duì)鞍區(qū)的病變進(jìn)行歸類(lèi)分析：

1、垂體腺：垂體腺瘤、Rathke’s囊腫、顱咽管瘤2、垂體柄：Rathke’s囊腫、顱咽管瘤、生殖細(xì)胞瘤、嗜酸性肉芽腫、轉(zhuǎn)移瘤3、視交叉：神經(jīng)膠質(zhì)瘤、脫髓鞘病變4、下丘腦：膠質(zhì)瘤、錯(cuò)構(gòu)瘤、生殖細(xì)胞瘤、嗜酸性肉芽腫5、腦膜：腦膜瘤、轉(zhuǎn)移瘤、感染性病變（結(jié)核性腦膜炎、結(jié)節(jié)?。?、蝶竇/顱底骨（斜坡）：鱗狀細(xì)胞癌、脊索瘤、肉瘤、轉(zhuǎn)移瘤、炎癥