大脑胶质瘤病的MRI病理对照研究——附8例分析

COMPARISON OF MRI AND PATHOLOGIC FEATURES OF GLIOMATOSIS CEREBRI——8 CASES ANALYSIS

目的探讨大脑胶质瘤病的ＭＲＩ特征。方法经ＭＲＩ诊断，活检与手术病理证实大脑胶质瘤病８例，其中活检５例、手术３例，分析了该组病变的分布范围，ＭＲＩ异常信号，肿块效应等ＭＲＩ表现，并与病理切片进行了对照研究。结果所有病例至少累及二叶，８８％浸润三叶以上，伴胼胝体侵犯５例，基底节和下丘脑侵犯３例，脑干侵犯２例，小脑侵犯１例。病变在ＭＲＩＴ２Ｗ成像上呈广泛高信号，囊变坏死较少，不形成肿块。ＭＲＩ信号异常区均可见镜下不同分化程度胶质肿瘤细胞浸润，多数为分化不良星形胶质细胞；少数为不同分化少枝胶质细胞。结论大脑胶质瘤病在ＭＲＩＴ２Ｗ成像上显示良好，肿瘤细胞弥漫浸润导致脑叶肿胀肥大。

Objective:To characterize the magnetic resonance images of gliomatosis cerebri.Methods:MRI studies of 8 patients with cerebral gliomatosis were reviewed respectively.Diagnosis were confirmed with operation(n=3) or biopsy(n=5).Distribution and extent of lesion, abnormal signal intensity and mass effect on MRI were recorded.Results:Tumor involved at least two lobes of the brain in all patients, with extension to corpus callosum in 5 cases, to basal ganglia and thalamus in 3,to brain stem in 2, and to cerebellum in 1. Wide spread invasion with hyperintensity was noted on T2weighted MRI. The MRI findings closely correlated with the pathological findings.Conclusion:Gliomatosis cerebri is best detected with MR imaging,the pattern is infiltrative with enlargement of cerebral structures.