视交叉-下丘脑胶质瘤MR特征及其鉴别诊断

Chiasmatic-hypothalamic gliomas:MR imaging features and differential diagnosis

目的:研究视交叉-下丘脑胶质瘤(CHG)的MR表现及临床特征。资料与方法:回顾性分析26例经手术病理证实的CHG,所有患者均行MRI平扫和增强扫描,分析患者的临床资料并对MR图像进行评估,观察肿瘤信号特点、囊变程度、强化特征及肿瘤范围及生长方式。结果:26例患者中,23例(88.46%)表现为视力、视野障碍,19例(73%)表现为头痛、头晕,少数表现为内分泌异常(8例)和中枢性尿崩症状(7例)。MRI图像上,肿瘤表现为视神经或视交叉结节样增粗,或表现为实性或实性为主的肿块,肿块内囊变程度低,T1WI多表现为等、低信号或等低混杂信号,T2WI大多表现为高或等高混杂信号。增强扫描后,肿瘤实性部分明显强化,肿瘤具有一定的侵袭性,常向周围组织侵袭性生长。结论:CHGMR表现和临床特征具有一定的特征性,了解这些特征有助于CHG的诊断。

Objective To study the MR imaging and clinical features of chiasmatichypothalamic gliomasCHG. Materials and Methods Twentysix cases of CHG confirmed by surgical and pathologic examination underwent plain and contrastenhanced MR imaging. The materials were reviewed retrospectively for clinical features and evaluation of MR imaging findings of tumors which included characteristic of intensity and contrast enhancement the extent of cysts as well as the pattern of growth. Results The clinical manifestations of visual disturbance were found in 23 cases and 19 cases had complaints of headache and dizziness. Few cases had endocrine changes and central diabetes insipidus. On MR imaging part of CHG presented as thickening of optic nerve and chiasma others manifested as solid and cystic tumors. The tumors on T1WI were manifested as iso hypo or isohypo mixed signal and hyperintense signal on T2WI. The solid content of tumors showed marked homogeneous enhancement after contrast injection. The growth of tumors was aggressive and usually invaded the adjacent tissues. Conclusion CHG have certain MR imaging findings and clinical features which are very helpful to make diagnosis and differential diagnosis.