复发脑胶质瘤的MRI影像特征及临床意义(附13例报告)

MRI imaging features of recurrent glioma and clinical significance( with a report of 13 cases)

目的总结脑胶质瘤患者术前、术后复发的MRI影像特征。方法选择13例经术后病理证实的脑胶质瘤再复发患者,归纳术前及术后再复发时的一系列MRI影像资料,分析肿瘤的原发部位、术后复发生长、扩散方式、最终侵袭部位等特点。结果 13例患者均表现有原位复发,10例复发后突破局部脑沟、软脑膜向邻近脑叶侵袭性生长,4例通过胼胝体向对侧侵犯,合并1例经脑脊液循环行室管膜下转移。结论脑胶质瘤患者术后具有原位复发、局部扩散、沿纤维传导束侵袭性生长、室管膜下转移等特点,肿瘤侵袭方向与侵及的纤维束有关。

Objective To summarize MRI imaging features of postoperatively recurrent glioma. Methods A total of 13 patients with pathologically confirmed recurrent glioma were selected. MRI image data after operation were analyzed, including the initial site, the way of growth and proliferation after surgery, the ultimate invasion site, and so on. Results In situ recurrence was found in all the 13 patients. And 10 patients suffered from invasive growth through local cerebral sulcus and pia mater into neighboring brain lobes, four ones suffered from invasion into contralateral hemisphere through corpus callosum and one suffered from invasion into subependymal brain tissue through cerebrospinal fluid circulation. Conclusion The recurrence of glioma has such characteristics as in situ recurrence, local spread, invasive growth along the fiber tracts and subependymal transfer. Invasion direction is related to the adjacent fiber bundle.