弥漫性星形细胞瘤的少见MRI表现

Rare MRI Findings of Diffuse Astrocytoma

目的研究弥漫性星形细胞瘤(DA)的少见MRI表现,提高对本病的认识。方法搜集2013年2月至2019年9月经病理证实的145例DA患者的术前MRI资料,回顾性分析其少见表现。结果筛选出具有少见MRI表现者29例,其少见表现有:(1)发病部位:肿瘤可位于皮层、侧脑室、穹隆、被盖、脑干、第四脑室等部位;(2)生长方式:肿瘤沿皮质脊髓束弥漫浸润生长;(3)影像特点:肿瘤呈囊性并见出血及液平;呈纯囊样表现;T2WI肿瘤呈稍低信号且边界清晰;为脑内多发肿瘤。结论皮层、脑深部及脑干等部位发生、沿皮质脊髓束弥漫浸润生长、显著囊变、肿瘤实质呈T2WI稍低信号、多发肿瘤等为DA的少见MRI表现,把握特点有助于术前影像诊断。

Objective To study the rare MRI findings of diffuse astrocytoma(DA)and to improve the understanding of the disease.Methods Preoperative MRI data of 145 patients with DA who were pathologically confirmed from February 2013 to September 2019 were collected,and their rare manifestations were retrospectively analyzed.Results 29 cases with rare MRI manifestations were selected.The rare manifestations are as follows:(1)location:tumors can be located in cortex,lateral ventricle,fornix,tectum,brain stem,fourth ventricle,etc.;(2)growth pattern:The tumor is diffusely infiltrating and growing along the corticospinal tract;(3)Imaging features:the tumor is cystic with hemorrhage and fluid-level;it has pure cyst-like appearance;the T2WI tumor is slightly low signal and clear;it is multiple tumors in the brain.Conclusion The occurrence in the cortex,deep brain and brainstem,diffuse infiltration and growth along the corticospinal tract,significant cystic transformation,tumor parenchyma with slightly low signal on T2WI,and multiple tumors are rare MRI manifestations of DA.Understanding the characteristics is helpful for preoperative imaging diagnosis.