17例脑胶质肉瘤的MRI特征及分析

The feature analysis of MRI of intracranial gliomasarcoma

目的探讨颅内胶质肉瘤的MRI特征性表现。方法回顾性分析17例经手术病理证实的颅内胶质肉瘤患者的影像及病理资料,总结脑胶质肉瘤的MRI诊断要点。结果本组MRI表现类型共4种:(1)11例表现为不规则团块状混杂信号,即T1WI混杂低信号,T2WI混杂稍高信号或高信号,静脉注入Gd-DTPA后可见病灶不均匀实质性强化,病灶占位效应显著,瘤周组织水肿明显。(2)3例不规则团块状等T1稍长T2信号影,瘤内包绕血管但未见囊变、坏死信号,病灶周边可见环状水肿信号,静脉注入Gd-DTPA后可见病灶明显均匀强化。(3)2例表现为等T1等T2信号影,周围可见大片状长T1长T2水肿影,静脉注入Gd-DTPA后可见病灶呈条带状明显强化影伴局部脑膜强化。(4)1例表现为等T1长T2类圆形病灶,其内可见更长T2,增强后厚壁不规则环形强化。结论脑胶质肉瘤的MRI表现复杂多样,但具有一定的影像学特征,有助于该肿瘤的诊断及鉴别。

Objective To investigate the MRI features and pathological findings in intracranial gliomasarcoma.Methods The MRI and pathological data of 17 patients with intracranial gliomasarcoma were retrospectively analyzed.Results Mixed hypo-isointense signal on T1 WI and hyper-isointense signal on T2 WI were observed in 11 cases,the lesion was inhomogeneously enhanced after administrating Gd-DTPA;The homo-isointense signal on T1 WI and slightly hyper-isointense signal on T2WI were found in 3 cases,the lesion showed the markedly homogeneous enhancement without necrosis,hemorrhage,and cyst formation;The homo-isointense signal on T1WI and T2 WI accompanying surrounded edema occurred in 2 cases,the lesion was the dura strap-shape enhancement after injecting Gd-DTPA;The homoisointense signal on T1 WI and hyperisointense signal on T2 WI were found in one case,the lesion showed thick-walled rim-like enhancement.Conclusion The MRI findings of intracranial gliosarcoma show typical features,and rare gliosarcoma should be highlighted in the differential diagnosis in the intracranial malignant tumors.