脑节细胞胶质瘤的CT、MRI表现及临床病理分析

CT and MRI features of ganglioglioma and clinical pathological analysis

目的:探讨脑节细胞胶质瘤的影像学特点。方法:结合临床病理特征,回顾性分析17例脑节细胞胶质瘤的CT及MRI表现,。结果:病灶全部为单发。幕上15例,幕下2例。颞叶6例,额叶5例,顶叶2例,胼胝体压部、额颞叶、左侧小脑半球及延颈髓各1例。其中15例为原发性肿瘤,2例为复发。CT检查3例,2例呈低密度影,1例等密度影,瘤周轻度水肿。1例邻近骨吸收,增强后无明显强化或轻度均匀强化。MRI检查16例,7例肿瘤脑回样分布,5例呈椭圆形或类圆形,余呈不规则生长。17例肿瘤中6例内有壁结节。肿瘤呈完全囊性、均匀实性,还可以囊性变。T1为均匀低信号或等低信号。T2为高信号或混杂信号,T2水抑制像上肿瘤边缘和实性呈高信号,其他部分呈等偏低信号,扩散加权像(DWI)上呈低或等偏低信号,表观扩散系数(ADC)值升高。瘤周境界较清,多数病例水肿占位效应不明显,增强后肿瘤不强化、轻度强化,也有不规则强化。结论:节细胞胶质瘤影像学较有特征性,有助于术前正确诊断。

Objective： To better characterize and report the images of the ganglioglioma （GG） in a series of 17 cases. Methods： Clinical and pathologic features of all cases were retrospectively studied. Results： This group included 17 patients. All cases demonstrated solitary lesion. Fifteen lesions located in supratentorial region, 2 lesions situated in the subtentorial region. Among them, 6 lesions located in the temporal lobe, 5 lesions located in the frontal lobe, 2 lesions located in the parietal lobe, 4 lesions located in the corpus callosum, frontal-temporal lobe, left cerebellum and medulla-cervical cord respectively. CT scan of 3 cases disclosed moderate hypodense lesion, 1 isodense, without peritumoral edema, 1 lesion with bone resorption. On MRI 7 lesions displayed gyriform granulose, 5 lesions were elliptical, the rest were irregular in shape. There were 6 mural nodule in 17 lesions. On TIWI the lesions appeared to be hypointense; T2WI, hyperintense or mixed signal; and absence of contrast enhancement. On T2 fluid attenuated inversion recovery weighted images, the margin and the mural nodule of the lesion appeared to be hyperintense. On DWI the lesions appeared to be isointense to hypointense, while the apparent diffusion coefficient（ADC） value was high. Conclusion： The typical neuroradiologic aspect of GG may be helpful for the diagnosis preoperatively.