弥散性神经胶质瘤病的临床诊断与治疗

Clinical diagnosis of diffuse neurogliomatosis: report of 4 cases

目的 提高临床诊断弥散性神经胶质瘤的水平。 方法 对 4例神经胶质瘤病例的临床症状、体征、MRI进行分析 ,2例开颅手术 ,2例CT立体定向活检术 ,均经病理证实为弥散性神经胶质瘤病。 结果 4例均有颅内压增高表现 ,除 1例病灶累及大脑 2个脑叶外 ,其余均累及大脑 3个叶。病灶在T1W1均呈低或等信号 ,在T2 W1上呈高信号。局部脑组织肿胀 ,无坏死囊变及出血 ,占位效应不明显 ,增强扫描无明显强化 ,3例胼胝体肥大增厚。 结论 MRI有其特有表现。手术或立体定向活检术是确诊该病的最佳选择。确诊后化疗及放疗应作为常规治疗的手段。

Objective To enhance the correctness in the diagnosis of diffuse neurogliomatosis. [WT5”HZ]Methods[WT5”BZ] Patients with diffuse neurogliomatosis were analyzed in terms of manifestations, signs, and MI images. Craniotomy was performed in 2 patients and stereotaxic biopsy in 2. The diagnosis was verified pathologically. [WT5”HZ]Results[WT5”BZ] Increased intracraniopressure was noted in all patients. Two brain lobes were involved in 1 patient, and 3 in others. MRI showed low or equal signal areas in T 1W 1, and high ones in T 2W 1. Brain edema was note without necrosis, cyst, and bleeding. MRI occupying effect was not significant, corpus callosum enlarged, and no enhancement demonstrated. [WT5”HZ]Conclusions[WT5”BZ] Diffuse neurogliomatosis has specific features on MRI. Craniotomy or stereotaxic biopsy was the best choice for diagnosis. Chemotherapy and radiotherapy should be used.