Objective： To evaluate retrospectively the MRI and MRS features of gliomatosis cerebri for investigating the clinical value of MR imaging and MR spectroscopy in the diagnosis of gliomatosis cerebri. Methods： Seven p...Objective： To evaluate retrospectively the MRI and MRS features of gliomatosis cerebri for investigating the clinical value of MR imaging and MR spectroscopy in the diagnosis of gliomatosis cerebri. Methods： Seven patients with gliomatosis cerebri proved clinically and histopathologically were analyzed retrospectively. All patients underwent MRI and three of them underwent MRS. Results： The tumors involved at least 2 cerebral lobes in all patients, with low signal intensity on TlWI and high intensity on T2WI. The area invaded by tumor showed cortex swelling and no obvious mass effect. The tumors presented small nodules or plaque lesions on enhance-MRI in 3 cases, and no contrast enhancement was shown in the rest 4 cases. All patients with MRS showed elevated Cho, Cho/Cr and Cho/NAA levels as well as varying degrees of decreased NAA. Conclusion： MRI is the method of first choice to detect gliomatosis cerebri so far, MR spectroscopy might be helpful in its differential diagnosis.展开更多
Gliomatosis Cerebri （GC） is a rare tumor of the central nervous system. It is defined as a diffuse glial tumor that extensively infiltrates the brain, involving more than two lobes. And it is listed as a subtype of ...Gliomatosis Cerebri （GC） is a rare tumor of the central nervous system. It is defined as a diffuse glial tumor that extensively infiltrates the brain, involving more than two lobes. And it is listed as a subtype of astrocytic tumors according to the newest 2007 （4th edition） WHO classification of tumors of the Central Nervous System. GC can be subdivided into Type I and Type II. Clinical findings for patients with GC are usually subtle and nonspecific. The lesions of GC generally show hypo, or isodensity on CT; a poorly defined diffuse hypoor isointense signal on Tl-weighted images, and a scattered diffuse hyperintense signal on T2-weighted images. Histological examination of GC reveals widespread infiltration of neoplastic glial cells with minimal destruction of pre-existing structures. Diagnosis of GC can be ascertained on the basis of a combination of clinical, radiological and pathological data. The treatment of GC includes radiotherapy and chemotherapy; however, the optimal therapeutic strategy is still not well established and prognosis of GC remains poor. This report reviews in detail the aspects of GC mentioned above, and three controversial issues are also discussed in the report.展开更多
Objective:To identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.Method:Patients who were clinically suspected to have Chiari malformation...Objective:To identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.Method:Patients who were clinically suspected to have Chiari malformation type 1 and were referred to the Department of Radiology between 2007 and 2020,and whose diagnosis was radiologically confirmed through magnetic resonance imaging(MRI),were retrospectively evaluated.A total of 49 Chiari malformation type 1 patients with both cervical and cerebral examinations and 49 control subjects of the same age and gender without a diagnosis of Chiari malformation type 1 were included in the study.In Chiari malformation type 1 diagnosed patients,the presence of pseudotumor cerebri,the presence of syringomyelia in cervical spinal MRI images,and the distance of cerebellar tonsils and obex according to McRae line were evaluated in millimeters.Result:In Chiari malformation type 1 clinically and radiologically diagnosed cases,the cerebellar tonsils and obex were located lower in patients with a radiological diagnosis of pseudotumor cerebri compared to those without,and the rate of accompanying syringomyelia appeared to be higher.However,no statistically significant difference was observed between the two groups.Conclusion:The coexistence of pseudotumor cerebri and Chiari malformation type 1 is more common than previously estimated.Different treatment protocols in the coexistence of pseudotumor cerebri and Chiari malformation type 1 emphasize the importance of making this diagnosis.Further radiological imaging studies are needed to identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.展开更多
Gliomatosis cerebri （GC） is a diffuse glial tumor that infiltrates the brain extensively. The optimaltherapeutic strategy for this tumor has not yet been established. Radiotherapy, temozolomide and other chemotherap...Gliomatosis cerebri （GC） is a diffuse glial tumor that infiltrates the brain extensively. The optimaltherapeutic strategy for this tumor has not yet been established. Radiotherapy, temozolomide and other chemotherapeutic modalities have been used to treat GC.2 Despite aggressive and often multimodal therapeutic intervention, survival rates for adult and pediatric patients with GC are extremely poor. Here we report two cases of GC in which we initially explored a new therapeutic strategy for this disease.展开更多
Gliomatosis cerebri(GC)is an uncommon disease,defined as diffuse infiltration of neoplastic glial cells involving at least three cerebral lobes.GCs in young population are rare.We described a case of 14-year-old woman...Gliomatosis cerebri(GC)is an uncommon disease,defined as diffuse infiltration of neoplastic glial cells involving at least three cerebral lobes.GCs in young population are rare.We described a case of 14-year-old woman with GC who did not receive any recommended treatment,because the patient’s family refused.The patient had a rapid deterioration in 5 months after first symptoms due to intratumoral bleeding.This is the first case report of intratumoral bleeding after diagnosis of GC is made,resulting in poor outcome.GC may acquire possibility of intratumoral hemorrhage through its development.展开更多
Aim:Gliomatosis cerebri(GC)is defined as a rare pattern of growth of diffuse gliomas involving three or more cerebral lobes.Given its rarity,it is difficult to define prognostic factors and standard of treatment.We re...Aim:Gliomatosis cerebri(GC)is defined as a rare pattern of growth of diffuse gliomas involving three or more cerebral lobes.Given its rarity,it is difficult to define prognostic factors and standard of treatment.We retrospectively analyzed patients(PT)with GC from a single institution with the aim of identifying the main prognostic factors and to assess optimal management.Methods:Medical records were reviewed of patients≥18 years with a histological and/or radiological diagnosis of GC(with no contrast enhancement)occurring between 2006 and 2017.Median progression free survival(PFS)and overall survival(OS)were calculated by the Kaplan-Meier method.Results:We analyzed 33 PT,22 males and 11 females;Eastern Cooperative Oncology Group(ECOG)performance status(PS)was 0-1 in 21 of the patients.Twenty-two PT underwent biopsy:16 were astrocytomas and 6 oligodendrogliomas.O6-methylguanin-DNA-methyltransferase(MGMT)was detected in 14 cases,and it was methylated in eight cases.Isocitrate dehydrogenase 1(IDH1)was analyzed in 16 PT,and it had mutated in 10 of them.Nine PT(27%)were treated with radiation therapy(RT)plus concurrent temozolomide(TMZ),22 PT(67%)received TMZ alone,and 2 PT(6%)underwent RT alone.We reported“complete response”in 1 patient(3%),partial response in 9 PT(27%),and stable disease in 15 PT(45%),while 8 PT(25%)had a progressive disease.For all PT,PFS and OS were 19.1 and 30.7 months,respectively.For ECOG PS 0-1 and≥2,PFS was 34.6 months vs.3.4 months(P<0.0001)and OS was 42 months vs.8.9 months(P<0.0001),respectively.Methylated MGMT was associated with longer PFS(41.6 months vs.8.9 months,P=0.05)and OS(52.7 months vs.14.6 months,P=0.009);PFS for IDH1 mutation and IDH wild-type was 52.7 months vs.8.9 months(P=0.006)and OS was 52.7 months vs.41.7 months(P=0.02),respectively.No significant difference was detected as regards treatments.With regard to histological subtype,OS was 42.0 months vs.52.7 months(P=0.8)and PFS was 41.6 months vs.28.6 months(P=0.7)for astrocytoma vs.oligodendroglioma,respectively.PT with treatment response showed a longer OS.PT receiving second-line treatment had a longer OS of 30.7 months vs.6.5 months(P=0.04).Conclusion:ECOG PS,MGMT methylation,and IDH1 mutational status seem to have an important prognostic significance,while the type of treatment does not seem to affect survival.Treatment response could be a surrogate marker for survival.展开更多
文摘Objective： To evaluate retrospectively the MRI and MRS features of gliomatosis cerebri for investigating the clinical value of MR imaging and MR spectroscopy in the diagnosis of gliomatosis cerebri. Methods： Seven patients with gliomatosis cerebri proved clinically and histopathologically were analyzed retrospectively. All patients underwent MRI and three of them underwent MRS. Results： The tumors involved at least 2 cerebral lobes in all patients, with low signal intensity on TlWI and high intensity on T2WI. The area invaded by tumor showed cortex swelling and no obvious mass effect. The tumors presented small nodules or plaque lesions on enhance-MRI in 3 cases, and no contrast enhancement was shown in the rest 4 cases. All patients with MRS showed elevated Cho, Cho/Cr and Cho/NAA levels as well as varying degrees of decreased NAA. Conclusion： MRI is the method of first choice to detect gliomatosis cerebri so far, MR spectroscopy might be helpful in its differential diagnosis.
基金supported by grants from National Science Foundation of China(No.30672159)New Century Excellent Talents of Chinese Universities(No.NCET-06-0306)
文摘Gliomatosis Cerebri （GC） is a rare tumor of the central nervous system. It is defined as a diffuse glial tumor that extensively infiltrates the brain, involving more than two lobes. And it is listed as a subtype of astrocytic tumors according to the newest 2007 （4th edition） WHO classification of tumors of the Central Nervous System. GC can be subdivided into Type I and Type II. Clinical findings for patients with GC are usually subtle and nonspecific. The lesions of GC generally show hypo, or isodensity on CT; a poorly defined diffuse hypoor isointense signal on Tl-weighted images, and a scattered diffuse hyperintense signal on T2-weighted images. Histological examination of GC reveals widespread infiltration of neoplastic glial cells with minimal destruction of pre-existing structures. Diagnosis of GC can be ascertained on the basis of a combination of clinical, radiological and pathological data. The treatment of GC includes radiotherapy and chemotherapy; however, the optimal therapeutic strategy is still not well established and prognosis of GC remains poor. This report reviews in detail the aspects of GC mentioned above, and three controversial issues are also discussed in the report.
文摘Objective:To identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.Method:Patients who were clinically suspected to have Chiari malformation type 1 and were referred to the Department of Radiology between 2007 and 2020,and whose diagnosis was radiologically confirmed through magnetic resonance imaging(MRI),were retrospectively evaluated.A total of 49 Chiari malformation type 1 patients with both cervical and cerebral examinations and 49 control subjects of the same age and gender without a diagnosis of Chiari malformation type 1 were included in the study.In Chiari malformation type 1 diagnosed patients,the presence of pseudotumor cerebri,the presence of syringomyelia in cervical spinal MRI images,and the distance of cerebellar tonsils and obex according to McRae line were evaluated in millimeters.Result:In Chiari malformation type 1 clinically and radiologically diagnosed cases,the cerebellar tonsils and obex were located lower in patients with a radiological diagnosis of pseudotumor cerebri compared to those without,and the rate of accompanying syringomyelia appeared to be higher.However,no statistically significant difference was observed between the two groups.Conclusion:The coexistence of pseudotumor cerebri and Chiari malformation type 1 is more common than previously estimated.Different treatment protocols in the coexistence of pseudotumor cerebri and Chiari malformation type 1 emphasize the importance of making this diagnosis.Further radiological imaging studies are needed to identify different radiological markers for the diagnosis of the coexistence of pseudotumor cerebri and Chiari malformation type 1.
文摘Gliomatosis cerebri （GC） is a diffuse glial tumor that infiltrates the brain extensively. The optimaltherapeutic strategy for this tumor has not yet been established. Radiotherapy, temozolomide and other chemotherapeutic modalities have been used to treat GC.2 Despite aggressive and often multimodal therapeutic intervention, survival rates for adult and pediatric patients with GC are extremely poor. Here we report two cases of GC in which we initially explored a new therapeutic strategy for this disease.
文摘Gliomatosis cerebri(GC)is an uncommon disease,defined as diffuse infiltration of neoplastic glial cells involving at least three cerebral lobes.GCs in young population are rare.We described a case of 14-year-old woman with GC who did not receive any recommended treatment,because the patient’s family refused.The patient had a rapid deterioration in 5 months after first symptoms due to intratumoral bleeding.This is the first case report of intratumoral bleeding after diagnosis of GC is made,resulting in poor outcome.GC may acquire possibility of intratumoral hemorrhage through its development.
文摘Aim:Gliomatosis cerebri(GC)is defined as a rare pattern of growth of diffuse gliomas involving three or more cerebral lobes.Given its rarity,it is difficult to define prognostic factors and standard of treatment.We retrospectively analyzed patients(PT)with GC from a single institution with the aim of identifying the main prognostic factors and to assess optimal management.Methods:Medical records were reviewed of patients≥18 years with a histological and/or radiological diagnosis of GC(with no contrast enhancement)occurring between 2006 and 2017.Median progression free survival(PFS)and overall survival(OS)were calculated by the Kaplan-Meier method.Results:We analyzed 33 PT,22 males and 11 females;Eastern Cooperative Oncology Group(ECOG)performance status(PS)was 0-1 in 21 of the patients.Twenty-two PT underwent biopsy:16 were astrocytomas and 6 oligodendrogliomas.O6-methylguanin-DNA-methyltransferase(MGMT)was detected in 14 cases,and it was methylated in eight cases.Isocitrate dehydrogenase 1(IDH1)was analyzed in 16 PT,and it had mutated in 10 of them.Nine PT(27%)were treated with radiation therapy(RT)plus concurrent temozolomide(TMZ),22 PT(67%)received TMZ alone,and 2 PT(6%)underwent RT alone.We reported“complete response”in 1 patient(3%),partial response in 9 PT(27%),and stable disease in 15 PT(45%),while 8 PT(25%)had a progressive disease.For all PT,PFS and OS were 19.1 and 30.7 months,respectively.For ECOG PS 0-1 and≥2,PFS was 34.6 months vs.3.4 months(P<0.0001)and OS was 42 months vs.8.9 months(P<0.0001),respectively.Methylated MGMT was associated with longer PFS(41.6 months vs.8.9 months,P=0.05)and OS(52.7 months vs.14.6 months,P=0.009);PFS for IDH1 mutation and IDH wild-type was 52.7 months vs.8.9 months(P=0.006)and OS was 52.7 months vs.41.7 months(P=0.02),respectively.No significant difference was detected as regards treatments.With regard to histological subtype,OS was 42.0 months vs.52.7 months(P=0.8)and PFS was 41.6 months vs.28.6 months(P=0.7)for astrocytoma vs.oligodendroglioma,respectively.PT with treatment response showed a longer OS.PT receiving second-line treatment had a longer OS of 30.7 months vs.6.5 months(P=0.04).Conclusion:ECOG PS,MGMT methylation,and IDH1 mutational status seem to have an important prognostic significance,while the type of treatment does not seem to affect survival.Treatment response could be a surrogate marker for survival.
