多发性胶质母细胞瘤MRI表现(附4例报告)

MRI Manifestations of Multiple Glioblastoma(Report of 4 Cases)

目的探讨4例经手术病理证实的多发性胶质母细胞瘤患者的MRI表现,并结合文献讨论其病理特点。资料与方法 4例经手术病理证实的多发性胶质母细胞瘤患者术前均行快速自旋回波(TSE)序列T1WI、T2WI、液体衰减反转恢复序列(FLAIR)、扩散加权成像(DWI)以及增强扫描,分析其病理特点与MRI表现。结果多发性胶质母细胞瘤的MRI表现主要为脑实质内大小不等,形态不一,伴不同程度的瘤周水肿和占位效应的多发病灶;T1WI呈低信号,T2WI呈混杂信号,FLAIR呈高信号、DWI呈不同程度弥散受限;增强扫描主病灶多呈典型的"花环"状强化,子病灶多根据转移时间的早晚呈结节状或不规则环形强化。结论多发性胶质母细胞瘤MRI多表现为脑实质内多发占位,病变形态不一,呈多种类型、不同程度的强化。

Objective To analyze the pathological features and MRI manifestations of multiple glioblastoma.Materials and Methods The MRI findings of four patients with operation confirmed multiple glioblastomas were analyzed retrospectively and the correlative literatures were reviewed.The patients underwent plain MR（T1WI,T2WI,FLAIR,DWI） and contrast enhancement MRI examination.Results The MRI findings demonstrated multiple lesions within the brain parenchyma,ranging in size,varies shape with different degrees of peritumoral edema and mass effect.The tumors showed low signal intensity on T1WI,heterogenous signal intensity on T2WI,high signal intensity on FLAIR and restricted diffusion on DWI.The primary lesions always showed typical chaplet enhancement,the metastatic lesions showed nodular or irregular ring enhancement according to the time of metastasis.Conclusion The MRI features of multiple encephalic lesions with variety of size,shape and heterogeneous enhancement should make a clue to make a diagnosis of multiple glioblastomas.