旁边缘系统胶质瘤的动态MRI变化及其临床意义

Dynamic MRI changes of gliomas located in the paralimbic system and the clinical significance

目的明确旁边缘系统胶质瘤生长扩散的影像学特点，为临床治疗提供参考。方法选择11例位于旁边缘系统、经病理证实为胶质瘤的患者，回顾性分析自初次发病到术前一系列MRI检查中病灶的部位变化、生长趋势及其与临床症状的联系。比较不同级别胶质瘤MRI检查周期及临床症状的差别。结果自初次MRI检查至术前，旁边缘系统一个以上组成单元受累的比率由64％（7／11）上升至100％（11／11）。64％（7／11）的患者以癫痫起病，91％（10／11）的患者术前症状加重。6例低级别胶质瘤与5例高级别胶质瘤MRI检查周期的差别无统计学意义（P〉0．05）。结论对旁边缘系统胶质瘤的治疗，要从整体出发，通盘考虑该系统所包含的全部解剖区域。

Objective To identify radiological growth features of gliomas located in the paralimbic system and to present suggestions for clinical treatment. Method Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proved by pathology. The serial MRI in each patient was analyzed, focused on location change and growth tendency. MRI change was compared with that of clinical symptoms. MRI examination period was calculated and compared in low grade gliomas and high grade gliomas. Results On the sequential MRI, more than one anatomical units of paralimbic system were involved, with a ratio from 64% （7/11） to 100% （11/11）. Clinically, 64% （7/11） of cases showed epilepsy at the onset. 91% （10/11 ） demonstrated aggravated symptoms before operation. MRI examination period showed no significant difference between 6 cases of low grade gliomas and 5 cases of high grade gliomas （ P 〉 0.05 ）. Conclusions Treatment strategy of gliomas located in the paralimbic system should be made with a whole insight into the total anatomic region.