不同级别少突胶质细胞瘤影像病理对照

Correlative analysis between imaging manifestations and pathological features of oligodendrogliomas in different grades

目的:通过探讨不同级别少突胶质细胞瘤的影像学特点并与病理表现对照,为少突胶质细胞瘤的临床治疗提供帮助。方法:回顾性分析57例经病理证实的不同级别少突胶质细胞瘤的影像表现,并和病理作对照。结果:少突胶质细胞瘤(WHOⅡ级)35例,中位年龄34岁,好发于额、顶叶皮髓质交界区,边界模糊,29例CT呈稍低密度,6例CT呈混杂密度,31例T1WI呈低信号,4例呈等信号,35例T2WI呈高信号,增强扫描32例呈轻度强化,3例呈不均匀强化,32例伴钙化,7例囊变,8例出血,5例伴瘤周水肿;间变少突胶质细胞瘤(WHOⅢ级)22例,中位年龄32岁,好发于额、顶、颞皮髓质交界区,边界较清,10例CT呈稍低密度,12例CT呈混杂密度,19例T1WI例呈低信号,3例呈等信号,19例T2WI呈高信号,增强扫描2例轻度强化,20例呈明显强化,3例伴钙化,12例囊变坏死,9例出血,22例伴瘤周水肿。结论:间变型少突胶质细胞瘤(WHOⅢ级)在囊变坏死、出血、瘤周水肿及强化形式方面较少突胶质细胞瘤更加明显,这些影像学特征有助于对该类肿瘤术前分级的诊断,为肿瘤的临床治疗提供帮助。

Objective： To explore the imaging features of different grades of oligodendrogliomas and pathological results for guidance of treatment.Methods： Imaging findings of 57 oligodenodrogliomas of different grades confirmed by pathology were retrospectively analyzed.Results： Thirty-five patients were grade Ⅱ oligodendrogliomas（WHO Ⅱ grade）,with a median age of 34 years.Most of the tumors occurred in the cortical and medullary junction of parietal and frontal lobes,with ill defined boundary.29 cases were slightly low density and 6 cases were mixed density on CT.On T1WI,31 cases showed low signal and 4 showed equal signal.On T2WI,35 cases showed high signal.Enhanced CT scan showed mild enhancement in 32 cases and heterogeneous enhancement in 3 cases.Thirty-two cases had calcification;7 cases had cystic degeneration;8 cases had bleeding and 5 cases had peritumoral edema.Anaplastic oligodendrogliomas（WHO Ⅲ grade） were found in 22 cases with a median age of 32 years.Most of the tumors occurred in cortex and medulla junction of frontal,parietal and temporal lobes,with clear boundary.On CT images,10 cases was slightly low-density,12 cases were mixed density.On T1WI,19 cases were low signal and 3 cases were iso-intense.19 patients showed high signal on T2WI.On enhanced CT scan,2 cases showed mild enhancement and 20 cases showed significant enhancement.3 cases had calcification;12 cases had cystic necrosis;nine cases had hemorrhage and 22 cases had peritumoral edema.Conclusions： Cystic necrosis,hemorrhage,edema and enhancement were more common in anaplastic oligodendrogliomas（WHO Ⅲ grade） than in glioblastoma.These imaging features contribute to tumor classification before surgery,and treatment planning for the tumor.