MRI判断星形胶质细胞瘤(AG)术前分级的准确性及复发者的征象特点

Accuracy of MRI in Diagnosis of Preoperative Grading of AG and Signs of Recurrent Patients

目的探讨MRI判断星形胶质细胞瘤(AG)术前分级的准确性及复发患者的MRI征象特点。方法选取68例AG患者为研究对象,以手术病理检查结果为依据,评估MRI对AG患者术前分级诊断的准确性。术后行为期1年的随访,分析复发患者的MRI征象。结果术前MRI检查对AG患者肿瘤分级的正确评估率为94.1%(64/68),其中WHOⅠ-Ⅳ级的准确率分别为86.7%(13/15)、95.0%(19/20)、96.3%(26/27)和100.0%(6/6)。术后1年的跟踪随访确诊复发9人,复发率为13.2%;MRI检查见13个复发灶,信号均匀1个(7.7%),信号不均匀12个(92.3%);无强化表现0个(0.0%),结节状强化1个(7.7%),片状强化2个(15.4%),花环状强化9个(69.2%),团块状强化1个(7.7%);瘤周轻度水肿1例(7.7%),中度水肿5例(38.5%),重度水肿7例(53.8%)。结论 MRI检查在AG患者术前分级及术后复发评估中均可发挥积极作用。

Objective To investigate the accuracy of MRI in preoperative grading of astrocytoma （AG） and MRI findings of recurrent patients.Methods 68 patients with AG were selected as the study subjects. Based on the surgical and pathological examination, the accuracy of MRI in diagnosis of preoperative grading of AG was evaluated. The patients were follow up for 1 year after operation. The MRI findings of recurrent patients were analyzed.Results The correct evaluation rate of MRI in tumor grading of AG was 94.1% （64/68） and the accuracy rates in WHO grade I - IV were 86.7% （13/15）, 95% （19/20）, 96.3% （26/27） and 100.0% （6/6） respectively. After 1 year of follow-up, there were 9 recurrent patients and the recurrence rate was 13.2%. MRI examination showed 13 recurrence foci, 1 homogeneous signal （7.7%） and 12 inhomogeneous （92.3%）; There was no enhancement in 0（0.0%）, nodular enhancement in 1（7.7%）, patchy enhancement in 2 （15.4%）, garland-like enhancement in 9 （69.2%） and mass like enhancement in 1 （7.7%）. There was 1 case with mild edema around tumor （7.7%）, 5 cases with moderate peritumoral edema （38.5%） and 7 cases with severe edema （53.8%）.Conclusion MRI examination can play an active role in the preoperative grading and postoperative recurrence evaluation of AG.