CT和MRI诊断脑神经胶质瘤52例分析

Cerebral glioma diagnosed by CT and MRI: fifty-two cases report

目的:探讨CT和MRI影像学在诊断脑神经胶质瘤中的作用。方法:回顾性分析2005年1月至2014年12月手术病理确诊的神经胶质瘤患者52例,男性27例,女性25例,年龄(24.5±10.8)岁。患者均进行头颅CT(增强扫描8例)和MRI平扫和增强扫描,这些检查均在术前1周内完成,并对结果进行分析,同时进行随访。结果:52例肿瘤直径1.6 cm^8.8 cm,均为单发,幕上42例和幕下10例。42例手术后进行放化疗,10例进行综合治疗。CT显示48例均表现为低密度或混杂密度肿块,4例表现为高密度肿块。MRI显示T1WI呈轻度低信号或等信号,T2WI呈高信号,26例有囊性坏死实性小肿块,22例含壁结节性大囊性肿块和4例单纯囊性肿块。神经胶质瘤进行WHO分级结果为:48例为Ⅰ~Ⅱ级,4例为间变型为Ⅲ~Ⅳ级。46例患者接受CT或MRI随访0.5年~6年,失去随访5例,32例病情稳定,9例行2次手术。结论:CT和MRI影像学诊断神经胶质瘤有重要的作用。儿童和青少年当肿瘤为囊变实性肿块和壁结节的囊性肿块,且有瘤周围水肿和钙化时应考虑为神经胶质瘤。

Objective To investigate the effects of CT and MRI in operation and pathology from Jan. 2005 to Dec. 2014, 52 patients the diagnosis for cerebral glioma. Methods Confirmed by with glioma were retrospectively analyzed, containing 27 males, 25 females, aged （24.5± 10.8） years. In a week before the operation, all patients finished CT scan （8 patients underwent enhancement scan）, MRI plain scan and enhancement scan. The results were analyzed. And the patients were followed up. Results The gliomas of the 52 cases were signal, with 1.6 cm-8.8 cm diameter, including 42 cases of supratentorial glioma and l0 cases of infratentorial glioma. Among the 52 cases, 42 cases underwent chemotherapy after operation, while another l0 cases were given comprehensive treatment. CT showed that 48 cases presented low density or mixed density mass, and 4 cases presented a high density mass. MRI showed that there was slight low signal or equisignal in T,WI, high signal in T2WI, and that there are 26 cases of solid small mass with cystic necrosis, 22 cases of wall nodular large cystic mass, and 4 cases of simple cystic mass. According to WHO standard, 48 cases of gliomas were graded as I-II, and 4 cases with the anaplastic were graded as III-IV. Forty-six patients were followed up for 0.5 years-6.0 years and were examined by CT or MR1. Five cases were lost to follow-up. Thirty-two cases were in a stable condition, and 9 cases underwent secondary operation. Conclusion CT and MRI play an important role in the diagnosis ofglioma. When the cystic solid masses and wall nodular cystic mass, with edema and calcification around the tumor, are found in the children and adolescents, glioma should be considered.