脑胶质瘤病的临床和MRI研究

Clinical and MRI manifestations of cerebral gliomatosis

目的 观察脑胶质瘤病的临床、病理、MRI特征 ,寻找本病患者生前确诊的方法。方法 对高度怀疑脑胶质瘤病患者 5例进行脑组织活检 ,将临床症状、影像学特点及病理做对照研究。结果 5例患者有进行性加重的头痛、呕吐等颅内压力增高表现 ,并伴有智能与精神障碍、癫痫、偏瘫等症状。影像学显示双侧大脑半球对称性弥漫性病灶 ,并灰白质均受累 ,占位效应不明显 ,没有显著强化 ,病理证实为脑胶质瘤病。肿瘤细胞在大脑半球灰白质中广泛增殖 ,主要在血管、神经元周围呈浸润性生长 ,不形成团块。结论 脑胶质瘤病的临床表现与影像学结合可帮助诊断 ,最终诊断仍需依靠病理学检查。

Objective To analyze the clinicopatholigical characterics and MRI features of cerebrel gliomatosis (CG). Methods Five case with CG were analyzed by clinical, radiological manifestations as well as pathological sections. Results All cases had headache, intracranial hypertension,and complicated with mental retardation, or dementia epilepsy,and hemiparesis. CT showed only slightly abnormal changes. MRI revealed diffuse lesions in both hemispheres without formation of a tumor mass. Histological examination showed the tumour cells diffusely intiltrating both cerebral hemispheres with perineronal,perivascular collectous, the underlying neuronal architecture was still preserred. Conclusion The clinical and radiological features were helptul to suggest the diagnosis of GC, however confirmation by brain biopsy is needed.