巨细胞型胶质母细胞瘤的MRI与病理结果对照:附9例报告

Comparison of MRI signs with pathological findings in giant cell glioblastoma:A report of 9 cases

目的 探讨巨细胞型胶质母细胞瘤的MRI特征。材料与方法 回顾性分析我院经手术病理证实的9例巨细胞型胶质母细胞瘤的MRI表现,并与病理结果对照。结果 MRI显示8例病灶均靠近脑表,其中7例单发,颞叶皮质-皮质下4例,顶叶皮质2例,枕叶皮质1例,侧脑室1例,1例多发,额顶叶多发病灶。边界清楚6例,边界模糊3例。瘤周轻度水肿7例,中度水肿2例。MRI平扫T1WI呈等或稍低均匀信号6例,T2WI呈等或稍高均匀信号6例,3例呈不均匀混杂长T1长T2信号。增强扫描呈显著均匀强化6例,明显坏死囊变3例,明显出血3例,脑膜尾征1例。病理上边界清楚7例,坏死囊变3例,出血3例。免疫组化胶质纤维酸性蛋白（GFAP）、S-100、波形蛋白（vimentin,Vim）染色均为阳性,Ki-67阳性细胞数达30%~50%。结论 巨细胞型胶质母细胞瘤影像表现有一定特征性,结合肿瘤好发的表浅部位、瘤周水肿轻、边界清楚等特点,对其影像学诊断有一定的帮助。

Objective：To analyze the MRI features of giant cell glioblastoma. Materials and Methods：The collection of 9 cases confirmed by operation and pathology in patients with giant cell glioblastoma MRI data. The imaging ifndings were analyzed and correlated with pathology.Results： （1） Position： 8 tumors of 9 patients were located cerebral superficial, with temporal lobe 4 cases, parietal lobe 2 cases, occipital lobe 1 case, frontoparietal 1 case and lateral ventricles 1 case. （2） Number： single lesion in 7 cases, multiple focal lesions in 1 case. （3） The MRI performance：① Six of 9 cases were margin clear.② Peripheral edema 7 cases of mild, 2 cases of moderate.③ Six cases showed homogeneously isointense or slightly hypointense on T1WI and isointense or slightly hyperintense on T2WI, 3 cases showed mixed hypointense on T1WI and hyperintense on T2WI.④ Enhance： Six tumors enhanced homogeneously and 3 cases enhanced heterogeneously. Intralesional obvious necrosis in 3 cases, hemorrhage in 3 cases, “dural tail sign” in 1 case. （4） Pathology：① Margin clear in 7 cases, necrosis in 3 cases, hemorrhage in 3 cases.② Immunohistochemistry： glial fibrilary acidic protein positive, Vimentin positive, high expression of Ki-67. Conclusion：Some imaging features can be found in giant cell glioblastoma. Combining imaging features with the location of lesion, mild peripheral edema and clear edge may contribute to diagnosis.