MRI及MRS在大脑胶质瘤病诊断中的应用

The Application of MRI and MRS in the Diagnosis of Gliomatosis Cerebri

目的:探讨MRI及MRS在大脑胶质瘤病诊断及鉴别诊断中的意义。方法:回顾性分析经穿刺病理或手术病理证实的5例大脑胶质瘤病患者,所有患者均行常规MRI检查及单体素MRS检查。结果:MRI常规图像显示所有病灶均呈浸润性生长但无明确肿块形成,病变累及区脑回肿胀、脑沟及脑裂变浅。5例患者均累及三个脑叶,其中同时合并单侧基底节区受累4例,合并胼胝体区受累5例。MRI常规图像所有病灶T1WI均呈弥漫性低信号,T2WI呈弥漫性高信号;增强扫描2例病灶内见斑片状强化区,所有病灶内未见明显坏死区或囊变区。MRS谱线显示5例病灶内谱线均表现为不同程度NAA峰降低,Cho峰升高,Cho/Cr比值及Cho/NAA比值升高。结论:MRI及MRS对大脑胶质瘤病的早期诊断及鉴别诊断具有重要作用。

Objective：To evalute the value of MRI and MRS in the diagnosis and differential diagnosis of Gliomatosis Cerebri. Methods：5 cases of Gliomatosis Cerebri which have been confirmed by pathology were analyzed retrospectively.all of these cases underwent MRI and MRS. Results：MRI revealed diffuse lesions located in hemisphere without mass formed,with slightly surrounding swelling,sulci disappearing.The tumor involved at least 3 lobes in all of the 5 cases,with lateral basal ganglia involved in 4cases,callosum involved in 5 cases.These lesions displayed with hypointensity on T1WI,hyperintensity on T2WI.After the administration of Gd-DTPA,plaque-like enhancement in 2 cases.The MRS images show that the NAA levels decreased,the Cho levels,Cho/Cr and Cho/NAA levels increased in all of these cases. Conclusions：MRI and MRS are valuable techniques for diagnosis and differential diagnosis of gliomatosis cerebri.