颅内神经节细胞胶质瘤的MRI诊断

MRI diagnosis of cerebral ganglioglioma

目的探讨颅内神经节细胞胶质瘤的MRI表现及鉴别诊断。方法回顾性分析经病理证实的24例颅内神经节细胞胶质瘤的MRI表现，患者均行MRI平扫及增强扫描。结果24例颅内神经节细胞胶质瘤中，单发23例，多发1例；幕上21例，累及额颞叶为主；幕下3例，累及小脑半球及脑干。病灶大小约2～10cm不等。不规则形12例、类圆形6例、脑回状6例。囊实性14例、实性7例、囊性3例，瘤周多无或轻度水肿，边界清晰，与脑实质分界清晰。平扫肿瘤囊性部分T，wI、TzFLAIR低信号，T2wI高信号，实性部分TzwI稍低信号，T2wI及TzFLAIR高或稍高信号；增强扫描肿瘤强化模式多样，可呈轻中度或明显均匀或不均匀强化。结论颅内神经节细胞胶质瘤MRI表现多样，但具有一定特异性，单发多见，好发于幕上，以额颞叶最为常见，囊实性多见，瘤周水肿程度轻，确诊还有赖病理及免疫组织化学证实。

Objective To explore the MRI features and differential diagnosis of cerebral gangliogliom. Methods MRI manifestations of 24 patients with cerebral gangliogliom confirmed by pathology were reviewed retrospectively. All of the patients underwent MRI plain and contrastenhancement scan. Results 23 of 24 cases were supratentorial, and 1 was mul tiple lesions, 21 of 24 cases were supratentorial and mainly located in the frontal and temporal lobe, and 3 of 24 cases were infratentorial and located in the cerebellum and brain stem. The tumors ranged in size from 2 to 10 cm in diameter. Con tours of the tumors were presented irregular in 12, round in 6 cases, and cerebriform in 6 cases. 14 of 24 cases were cystic and solid, 7 cases were solid, whereas, 3 cases were cystic, which appeared clear margin with brain parenchyma and light or no peritumoral edema. The enhancement pattern of tumor was variegated, which can be mild to moderate or obvious homogeneous or inhomogeneous enhancement. Conclusion MRI manifestations of cerebral ganglioglioma are diversitie, but have some speeificities, which are mainly single, cystic and solid, supratentorial, mainly located in the frontal and temporal lobe, with light peritumoral edema. The final diagnosis should be confirmed by pathology and immunohistochem istry.