星形细胞瘤的影像学表现与病理学分级的对照性研究

The Comparative Study of Imaging Findings and PathologicaI Grading of Astrogliomas

目的探讨不同分级的星形细胞瘤影像学表现。方法回顾分析67例经手术病理证实的Ⅰ～Ⅳ级星形细胞瘤影像学表现。结果Ⅰ级星形细胞瘤5例，轻微占位效应1例，信号均匀5例，无瘤内血管及出血，轻度增强4例，其中均匀3例，欠均匀1例；Ⅱ级46例，占位效应11例，较轻，信号均匀41例，瘤内血管9例，出血4例，均匀增强41例，其中均匀32例，欠均匀9例；Ⅲ～Ⅳ级16例，占位效应14例，信号不均匀15例，瘤内血管14例，9例出血，不均匀明显强化15例；信号不均、占位效应明显，瘤内血管6例及3例出血，呈不均匀明显强化。Ⅲ-Ⅳ级与Ⅰ、Ⅱ级星形细胞瘤影像学表现具差异性有统计学意义（P〈0．05）。结论不同分级的星形细胞瘤具有一定的MRI特征性，不均匀信号和强化、瘤内血管及出血坏死对诊断Ⅲ～Ⅳ级星形细胞瘤有帮助。

Objective To discuss the relationship between the imaging findings and pathological grading of the brain astroglioma. Methods The Imaging findings of 67 cases with astroglioma were retrospectively reviewed in comparison with operation and pathology. Results In grade Ⅰ and Ⅱ ,the tumor showed slight mass effect, homogeneous signal intensity, and mild edema, there was no vessel and hemorrhage within the lesion. The tumor was enhanced slightly and homogenously. In grade Ⅲ-Ⅳ, the tumor showed heterogeneous signal intensity, marked mass effect and edema. The vessels and hemorrhage within tumor were demonstrated respectively. The tumor was enhanced strongly and heterogeneously after administration of contrast medium. There are different imaging findings between malignant glioblastomas and grade Ⅰ and Ⅱ of astroglioma（P 〈 0. 05）. Conclusion The imaging findings of malignant glioblastomas are of some speciality in the diagnosis. Moreover, the marked mass effect and edema, the vessels and hemorrhage may lead to the diagnosis of malignant glioblastoma.