摘要
目的研究瘤样脱髓鞘病（tumefactive demyelinating lesion．TDL）在增强MRI和MRS上的特征性表现及特定情况下该病的手术方式。方法将9例确诊的TDL增强MRI和MRS表现与Ⅲ～Ⅳ级胶质瘤作对照研究，比较其影像学特征和NAA峰、CHO峰、LAC峰的变化。根据患者具体情况和手术目的选择相应手术方式。结果TDL增强MRI上的特征性表现，尤其是开环征和线样征对该病与胶质瘤的鉴别诊断具有一定意义，MRS上NAA峰、CHO峰、LAC峰的高低对TDL和胶质瘤的表现有明显差别。采用合理手术方式有利于明确诊断，效果良好。结论增强MRI及MRS的特征性表现对TDL具有鉴别意义，但需注意动态观察和综合判断。特定情况下的手术并非不当，需注意手术方式的合理选择。
Objective To investigate the characteristic manifestations of tumefactive demyelization lesion（TDL） on enhanced MRI and MRS and discuss the surgical methods in some specific circumstances. Methods A retrospective analysis was done for 9 TDL cases. Their enhanced MRI and MRS manifestation was studied compared with Ⅲ ～Ⅳ grade gliomas, some characteristic manifestations and changes of NAA,CHO and I.AC peak on MRS were studied. Different surgical methods were selected according to individual condition and operational purpose. Results The characteristic manifestations of TDL on enhanced MRI, especial open-ring sign and linear sign, were significant in differentiate TDL and glioma. The height of NAA,CHO and LAC peak on TDL MRS also have obvious differences with glioma. Rational surgical method was helpful in confirming the diagnosis and had good clinical outcome. Conclusion Some characters of enhanced MRI and MRS of TDL have importent diagnosis significance, though attention should be paid to dynamic observation and comprehensive evaluation. Operation in some specific circumstances is reasonable and appropriate.
出处
《江西医学院学报》
2008年第3期66-69,共4页
Acta Academiae Medicinae Jiangxi
