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四、脑室与脑池疾病鉴别诊断
1.第四脑室常见肿瘤的鉴别诊断
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image76.jpeg?sign=1739342550-oDWwR5A1waDZYTK21ujqwgoEDMVWv7Cu-0-b731af3f4f8eb04f91fdf9f655374438)
图1-4-1 室管膜瘤
CT平扫显示第四脑室区不规则软组织密度肿块影(→),呈稍高密度,其内散在斑点状钙化灶
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image77.jpeg?sign=1739342550-5ez9RH3oGbteAIhkPj5EuMCQs9JF0GND-0-00e702733caca6fe77d3729568b46680)
图1-4-2 髓母细胞瘤
CT平扫显示小脑蚓部椭圆形软组织密度肿块影(→),灶周可见带状水肿带围绕,第四脑室受压、移位
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image78.jpeg?sign=1739342550-0P1dquH7YzeWNwKT0JbXuDKf1AcKEhM5-0-0107572f86259632057f30d167fca0cb)
图1-4-3 脉络丛乳头状瘤
CT平扫显示第四脑室内分叶状高密度软组织肿块影(→),其内可见点状钙化
2.侧脑室常见肿瘤的鉴别诊断
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image80.jpeg?sign=1739342550-FHWgA8ERmxZJnX8Ai2WFnk1xZfJuZDsp-0-74ade93d635f95417660248598bcd544)
图1-4-4 室管膜瘤
(A)显示左侧脑室三角区囊实性病变(→),跨越脑室和脑实质生长;(B)可见明显花环状强化(→)
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image81.jpeg?sign=1739342550-D6bT1Ead11lnH3NIW28sgLHaaAyrivFn-0-6dd8972c4c89eb42088c6d6b90176fc1)
图1-4-5 侧脑室内脑膜瘤
CT增强扫描显示右侧脑室三角区可见椭圆形软组织肿块影(→),均匀强化
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image82.jpeg?sign=1739342550-Cg0Pxr76f8GlyEs0OVxVgbxURhoznJHC-0-66e01416d91047e5d286afd5aace7b27)
图1-4-6 室管膜下巨细胞星形细胞瘤
(A)显示右侧脑室前角近孟氏孔附近椭圆形等密度肿块影,邻近侧脑室多发结节状钙化灶(→),提示同时合并结节性硬化;(B)可见结节明显强化(→)
3.第三脑室肿瘤的鉴别诊断
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image84.jpeg?sign=1739342550-MV7ztFvtEwqYPk9sB4xcCcmIlBtT1qCX-0-98d629bce344bc2d06065bd15375efef)
图1-4-7 胶样囊肿
CT平扫显示第三脑室前部圆形高密度灶(→),病灶边界清晰
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image85.jpeg?sign=1739342550-RJyatMf9FA7z9szJXNdmuIqsFfLm4kl3-0-49aa23e3406750ede807bf9319c072d8)
图1-4-8 松果体细胞瘤
CT增强扫描显示松果体区椭圆形肿块影(→),明显强化
![](https://epubservercos.yuewen.com/6D40E4/14262446004375506/epubprivate/OEBPS/Images/image86.jpeg?sign=1739342550-P1NMgjAo9RFHbcoIJRZhkQhSK7WAEqH2-0-89cb0660e255ed1e86f5737a24833c31)
图1-4-9 毛细胞型星形细胞瘤
CT平扫显示四叠体区稍高密度肿块影(→),其内散在斑点状钙化灶