脑胶质细胞增生的磁共振成像研究

Magnetic Resonance Imaging of Glial Cell Hyperplasia in Patients with Brain Gliosis

目的研究脑胶质细胞增生的磁共振成像(MRI)表现,并分析其特征以提高对该病的诊断价值。方法回顾性分析2005年1月至2009年12月经开颅手术和病理检查证实、且有完整记录的脑胶质细胞增生患者18例的MRI表现,病程4个月至5年,平均2.5年。症状为头痛、头晕13例,面部肌肉抽搐3例,反复发作性意识丧失2例。扫描设备用GE Sigma 1.5 T MR扫描仪,均行常规MRI和增强扫描。结果 18例患者中,病变位于右侧颞顶叶和左侧颞叶各5例,右侧额叶4例,脑桥左侧3例和左侧小脑半球1例。组织学表现为神经节细胞变性、神经细胞嗜节现象及胶质细胞增生。MRI显示,病变直径1.6～4.8 cm,病灶表现为皮质或皮质下脑组织肿胀,呈片状略长T1、长T2信号;在液体衰减反转恢复序列T2加权成像上病灶呈略高信号。结论 MRI对脑胶质细胞增生的诊断正确率较高且能综合多序列影像,对脑胶质细胞增生的基础和临床研究具有一定的指导作用。

Objective To study magnetic resonance imaging（MRI） findings and characteristics of brain glial cell hyperplasia（BGCH） and to improve the diagnostic value of MRI in BGCH.Methods We retrospectively analyzed MRI findings of 18 patients undergoing craniotomy surgery and with pathologically documented BGCH from January 2005 to December 2009.The disease course ranged from 4 months to 5 years,at a mean of 2.5 years.The symptoms included headache and dizziness（n=13）,facial muscles twitch（n=3）,and loss of consciousness（n=2）.A GE Sigma 1.5 T MR Scanner was used for conventional and contrast-enhanced MRI scans.Results Out of 18 patients,the lesions were identified to be located at right temporofrontal lobe（n=5）,left temporal lobe（n=5）,right frontal lobe,left pons（n=3）,and left Cerebellar hemisphere（n=1）.These lesions manifested histologically as glial cell degeneration,neuronophagia,and glial cell hyperplasia.MRI scan showed that the disease was 1.6 ～4.8 cm in diameter and presented patch-like high-T1-and high-T2-weighted signal from cortical or subcortical brain swelling.Fluid-attenuated inversion recovery pulse sequence T2-weighted imaging exhibited a slightly high signal.Conclusion MRI has a high diagnostic accuracy for BGCH by integrating multiple sequence imaging and is instrumental for preclinical and clinical studies of BGCH.