摘要
目的探讨大脑胶质瘤病(GC)的MRI表现特点及其病理基础。资料与方法分析经活检、手术病理证实的12例GC的MRI表现特征,并与病理切片进行对照研究。对其中8例于同期行常规头颅CT扫描。结果MRI显示GC病变广泛,11例(91.7%)累及三叶以上大脑,以额、颞、顶叶受累多见。病变区脑组织肿胀,无囊变、钙化和肿块形成,占位效应不明显,周围正常脑组织结构仍可辨识。同时伴胼胝体侵犯10例(83.3%),基底节和丘脑侵犯5例,脑干侵犯3例,小脑和脊髓侵犯各1例。病变在T1WI上均以低信号为主;T2WI、液态衰减反转恢复序列(FLAIR)上均为均匀高信号。增强扫描10例(83.3%)无强化。8例CT扫描仅显示大脑弥漫性等或低密度,显示的病变范围均小于MRI。在病理上表现为不同分化程度的胶质肿瘤细胞在神经束间、神经细胞及血管周围浸润性生长,其中纤维型星形细胞瘤8例,胖细胞型星形细胞瘤2例,混合型星形细胞瘤和少枝胶质瘤各1例。结论MRI不仅能反映GC的病理特性,而且能清楚显示肿瘤在颅内的侵犯范围,是诊断GC的首选影像学方法。
Objective To evaluate the correlation between MRI manifestations and pathologic findings of gliomatosis cerebri （GC）. Materials and Methods The MRI features and the pathologic findings of 12 patients with cerebral gliomatosis confirmed with stereotactic biopsy （ n = 8） or operation （ n = 4） were reviewed, and 8 patients were also performed with CT at the same period. Results MRI showed tumor involved at least three lobes of the brain in 11 patients （91.7 % ）, the frontal, temporal and parietal lobe were commonly involved, with extension to corpus callosum in 10 cases, to basal ganglia and thalamus in 5 cases, to brain stem in 3 cases, and to cerebellum and spinal 1 case, respectively. Wide spread invasion with hypointensity on T1 weighted, and hyper intensity on T2 weighted and FLAIR sequence with slightly surrounding swelling, without cystic change and calcification, less mass effect were noted. On enhanced MR scans, no enhancement was seen in 10 cases, diffuse isodensity or hypodensity of cerebral was depicted on CT scan, the extent of lesions was less depicted on CT than that on MRI. Pathologic results showed the astrocyte cell diffuse overgrew along the nerve fiber and the peri-vessel, and the MRI features were closely correlated with the pathological findings. Conclusion MRI not only can reflect the pathologic changes of GC, but also clearly depict the extent of tumors in cerebral, so it is the first choice in diagnosis of GC.
出处
《临床放射学杂志》
CSCD
北大核心
2006年第8期702-706,共5页
Journal of Clinical Radiology
关键词
神经胶质瘤
脑肿瘤
磁共振成像
病理
Gliomatosis cerebri Magnetic resonance imaging Pathology
