原发脑胶质肉瘤的MRI征像分析

MRI features of primary cerebral gliosarcoma

目的探讨原发脑胶质肉瘤的MRI特征。方法回顾性分析7例经手术病理证实原发脑胶质肉瘤患者的临床资料及MRI表现并进行文献复习,所有病例均行常规MRI平扫及增强扫描。结果 7例肿瘤均位于幕上,颞叶3例,额叶2例,额顶叶1例,枕叶1例。平扫T1WI呈低信号,T2WI呈高信号,6例肿瘤信号不均匀,内部见片状坏死、囊变区,所有肿瘤周围均见轻中度水肿区。增强扫描肿块均明显强化,6例呈不规则环形强化,1例呈结节状强化;4例肿瘤内部见索条状强化灶,3例见强化结节。其中4例肿瘤发生于大脑凸面紧邻硬脑膜。结论原发脑胶质肉瘤的MRI表现具有一定特点,结合临床表现,可提高术前诊断正确率。

Objective To analyze the MRI features of primary cerebral gliosarcoma. Methods Clinical and MRI manifesta- tions of 7 patients diagnosed as primary cerebral gliosarcoma by operation and pathology were retrospectively analyzed, and the lit- eratures were reviewed. All cases were performed plain and enhanced MRI scanning. Results All seven gliosarcomas were loca- ted in the supratentorial area, with three cases in the temporal lobe, two in the frontal lobe, one in the frontoparietal lobe, and one in the occipital lobe. On MR images, all tumors showed hypointense on T1 WI and hyperintense on T2 WI, and six tumors re- flected mixed signal, which corresponded to solid masses with necrosis and cystic changes. Mild or moderate peritumoral edema were seen in all cases. Contrast-enhanced MRI demonstrated strong enhancement in all tumors, six of which had irregular ring-like enhancement and one of which had nodular enhancement. Irregular enhanced strips were found in four cases and enhanced nodules were in three cases. Four cases occurred on the convexity surface, next to the dura. Conclusion The MRI findings of gliosareo- ma are considerably characteristic. When combined with relevant clinical information, the correct rate of the tumor diagnosis can be improved.