摘要
目的评价MRI、MRS对大脑胶质瘤病诊断及病理分级的临床价值。方法对11例经病理证实的大脑胶质瘤病MRI平扫、增强及病灶MRS综合影像学资料进行回顾性分析。结果所有病例均侵犯两个或两个脑叶以上,以颞叶、额叶、胼胝体常见,分别为91%、64%、64%。MRI表现:T1WI呈低或等低信号,T2WI呈高或混杂高信号,FLAIR像敏感,呈高信号,受累区脑组织轻度肿胀,邻近脑裂、沟变浅或消失,占位效应轻。注射Gd-DTPA增强扫描示4例不规则、结节状强化,1例肿块样强化,2例线状轻度强化,4例无强化。DWI3例弥散受限,8例弥散不受限。MRS:5例强化患者行MRS分析,胆碱复合物(Cho)升高明显,肌酸(Cr)中等程度的升高,N乙酰天门冬氨酸(NAA)和乳酸、脂质(LL)降低,Cho/Cr(平均2.458)、Cho/NAA(平均3.988)比值升高,肿块样强化患者MRS数值变化明显.病理:肿瘤分级6例为星形细胞瘤I-II级,4例(强化)II-III级,1例(肿块样强化)IV级。结论 MRI、MRS对大脑胶质瘤病的诊断及病理分级有重要的临床价值。
Objective To evaluate the clinical value of diagnosis and pathologic grade of Gliomatosis cerebri with MRI and MRS. Methods MRI and MRS studies of 11 cases with Gliomatosis cerebri which has been confirmed by pathology was analyzed retrospectively. Results These tumors involved more than two cerebral lobes at least in all patients, especially temporal lobe（91%）, frontal lobe（64%） and corpus callosum （64%）. They demonstrated low or iso-low signal intensity on T1WI, hyperintensity on T2WI, especially on FLAIR, with slightly surrounding swelled, sulcus disappeared and poor space occupying effect .After Gd-DTPA injection, nodular or irrigular enhancement （n=4）, mass-like enhancement（n=1）, poor striped enhancement （n=2） and, no contrast enhancement （n=4） were showed. The diffusion of 3 leisions was limited in DWI, the rest one unlimited. Cho, Cr, Cho/Cr（mean 2.458）, Cho/NAA（3.988） levels were elevated on MRS and NAA,LL levels were decresed .the pathological diagnosis were all astrocytoma, including grade I-II（n=6）, grade II-III（n=4）, grade IV（n=1）. Conclusion MRI and MRS have significantly clinical value in the dianosis of glimatosis cerebri and pathologic grade.
出处
《中国CT和MRI杂志》
2010年第3期74-76,共3页
Chinese Journal of CT and MRI
