大脑胶质瘤病的MRI特点研究

Study on MR imaging manifestations of gliomatosis cerebri

目的探讨大脑胶质瘤病的MRI特点。方法对14例经手术(或活检)、病理证实的大脑胶质瘤病患者的MRI和临床资料进行回顾性分析。结果大脑胶质瘤病的临床表现以头痛(12/14)和癫痫(7/14)为常见,后期多出现严重颅高压征象。MRI提示病灶呈多灶性生长9例,弥漫性生长5例,至少累及2叶脑组织。T1WI呈等或稍低信号灶,T2WI为等或高信号灶,轻至中度水肿,占位效应轻。增强扫描常见肿瘤轻度强化。星形胶质瘤Ⅰ级7例,Ⅱ级5例,少枝胶质瘤Ⅱ级1例,少枝一星形混合胶质瘤Ⅱ级1例。结论大脑胶质瘤病的影像学表现与某些神经系统病变有类似和重叠之处,但通过影像与临床表现的结合,有利于该病变的诊断与鉴别诊断。

Objective To investigate the magnetic resonance imaging （MRI） features of gliomatosis cerebri. Methods MRI and clinical data of 14 cases who were definitely diagnosed as gliomatosis cerebri by the operation （or biopsy） and pathological examination, were retrospectively analyzed. Results The primary manifestations of gliomatosis cerebri were dominated by headache （12/14） and seizure （7/14）, and symptoms and signs of severe intracranial hypertension occurred frequently at the later stage. MRI scan indicated that at least two cerebral lobes were involved by multiple lesions of 9 cases and diffuse-type tumors of 5 cases. The lesions were isointense or slightly hypointense on T1-weighted images （T1WI） and isointense or hyperintense on T2-weighted images （T2WI）. The severity of edema was mild or moderate and mass effect, mild. Contrast-enhanced CT scan showed that tumors were frequently slightly enhanced. A total of 12 cases with low-grade astrocytomas （grade Ⅰ ： 7 cases; grade Ⅱ ： 5 cases）, 1 case with grade Ⅱ oligodendroglioma and 1 case with grade Ⅱ mixed oligo-astrocytoma were pathologically proved. Conclusion MRI findings of gliomatosis cerebri are analogous to or overlap with some lesions of the nervous system, but with the combined application of imaging and clinical manifestations, diagnosis and differential diagnosis of this disease shall be more effective.