症状性癫相关原发脑肿瘤的临床及MRI观察

Clinical and MRI observations of symptomatic epilepsy-related primary brain tumors

目的探讨症状性癫相关原发脑肿瘤的临床与MRI表现。方法回顾性分析50例继发于原发脑肿瘤的癫病人的临床资料。所有病人均行头部MRI扫描,分析致脑肿瘤的大小、累及部位、发病年龄与癫发作类型、肿瘤病理类型的关系及其MRI表现。结果颞叶肿瘤引发的复杂部分性发作显著多于额叶肿瘤(χ2=14.368,P=0.001)。肿瘤直径>3.0 cm组中各类胶质瘤比例显著多于直径≤3.0 cm组(χ2=19.348,P=0.013)。发病年龄≤18岁组中低级别胶质瘤比例显著多于>18岁组(χ2=8.008,P=0.005)。结论症状性癫相关性原发脑肿瘤易累及颞叶及额叶的皮质区,并以复杂部分性发作伴或不伴全身强直阵挛发作多见。肿瘤以未成年发病者居多,多为低级别、体积较小且生长缓慢的肿瘤。

Objective To explore the clinical manifestation and MRI in patients with symptomatic epilepsy-related primary brain tumors. Methods Clinical data of 50 patients with symptomatic epilepsy second to primary brain tumors who underwent cranial MRI examination were analyzed retrospectively. The correlations between size, site and onset age of brain tumors and types of epileptic seizure and pathology were analyzed, and MRI results were observed in the same time. Results Complex partial seizures were more common in temporal lobe tumors than that of frontal lobe tumors （χ2=14.368, P=0.001）. The ratio of gliomas in tumors with diameter of more than 3.0 cm was significantly higher than that of less than or equal to 3.0 cm （χ2=19.348, P=0.013）. The ratio of low grade gliomas in the patients with onset age less than or equal to 18 years was markedly higher than that of more than 18 years （χ2=8.008, P=0.005）. Conclusions The symptomatic epilepsy-related primary brain tumors are more likely involved in the temporal or frontal lobes cortex, and the epilepsy is more common with complex partial seizures with or without generalized tonic-clonic seizures （GTCS）. The tumors are usually of low grade, small size, slow-growing and more common in juveniles.