脑干胶质瘤磁共振成像影像与病理分级关系的临床研究

Clinical study on the corration of pathological classification of brainstem glioma with MRI imaging

目的:探讨脑干胶质瘤(BSG)病理分级与磁共振成像(MRI)影像的关系。方法:对98例BSG患者的临床资料进行回顾性分析,按病理级别将其分为两组,其中66例为低级别组BSG,32例为高级别组BSG,并分析不同病理分级BSG的MRI影像表现。结果:对两组患者胶质瘤生长方式进行比较无差异,但高级别组基底动脉包绕、坏死及跨中线生长的比例显著高于低级别组,两组相比差异有统计学意义(x2=15.548,x2=22.970,x2=9.393;P<0.01)。而低级别组患者囊性病变的比例明显高于高级别组,差异有统计学意义(x2=7.625,P<0.01)。高级别组肿瘤直径>2 cm的患者比例高于低级别组,差异有统计学意义(x2=5.331,P<0.05)。高级别组强化形态主要以花环样、壁结节为主,强化程度明显强于低级别组,强化均匀性方面主要表现为不均匀性特征。两组MRI测量最小厚度比较无差异,但高级别组MRI测量最大厚度、最大厚度与最小厚度的比值及差值明显大于低级别组,差异有统计学意义(t=-22.689,P<0.001)。结论:BSG的MRI影像及MRI增强特征可预测和判断BSG的病理分级及恶性程度。

Objective：To explore the corration of pathological classification of brainstem glioma with MRI imaging. Methods： The clinical data of 98 patients with BSG was retrospectively analyzed. of 98 patients, 66 cases were low level of brainstem gliomas, 32 cases were high level of brainstem gliomas. MRI images of different pathological grading of BSG were analyzed. Results：Glioma growth way was similar between the two groups and there was no statistical significance. But the proportion of basal artery circumvolutio, necrosis, growth across the midline of the high level group were significantly higher than the control group, there was a significant statistical significance （P〈0.01）. And the proportion of the cystic lesion in patients of low level group was obviously higher than that of high level group, with significant difference （P〈0.01）. of high level group patients with a ratio of tumor〉2 cm in diameter was higher than the control group, and the difference was statistically significant （P〈0.05）. The improved forms of high level group were mainly wreath, wall nodules （P〈0.01）, and improved significantly stronger than the low level group （P〈0.01）. The main uniformity of high level group in show was characteristics with less uniformity （P〈0.01）. The MRI measuring minimum thickness was similar between the two groups and had no statistical significance. But MRI measuring thickness, the ratio and gap between maximum thickness and minimum thickness of high level group were bigger than the value of low level group, with statistically significant difference （P〈0.001）. Conclusion：MRI imaging and MRI enhanced characteristics of brainstem glioma may predict and judge the malignant degree and pathological grading of brainstem glioma.