弥漫性星形细胞瘤的MRI与CT联合诊断及病理分析

Combined Diagnosis of MRI and CT in Diffuse Astrocytoma and Pathological Analysis

目的分析弥漫性星形细胞瘤MRI及CT影像学特征,总结其诊断价值。方法回顾性分析2011年6月-2015年5年于我院经手术及病理证实为弥漫性星形细胞瘤的36例患者的临床资料,分析其CT、MRI表现与特点,与病理对照,评估MRI、CT联合诊断价值。结果病理分级:Ⅱ级13例,Ⅲ级12例,Ⅳ级8例;病灶最大直径2.1-8.2cm,平均(4.5±0.2)cm。;2例病变位幕下,34例位于幕上,以其额叶、颞叶病变多见;大部分可见边界不清、弥漫性异常信号灶;19例周围均无水肿,未见显著占位效应,仅12例可见轻中度脑水肿,5例可见侧脑室受压、中线结构移位。T1WI序列呈等低信号,T2WI序列呈高信号,CT扫描可见肿瘤边界模糊低密度灶;17例未见明显强化,15有轻中度强化表现,可见结节、小斑块状或非规则环状强化。结论弥漫性星形细胞瘤以青年常见,影像学表现有其特殊性,采用MRI联合CT检查,可实现多方位、多角度成像扫查,有助于其鉴别诊断。

Objective To analyze the imaging findings of MRI and CT of diffuse astrocytoma and to summarize the diagnostic value. Methods The clinical data of 36 patients with diffuse astrocytoma confirmed by operation and pathology in our hospital from June 2011 to May 2015 were retrospectively analyzed. The findings and characteristics of CT and MRI were analyzed and compared with pathology. The combined diagnostic value of MRI and CT was evaluated. Results Pathological grading showed that there were 13 cases of grade Ⅱ, 12 cases of grade Ⅲ and 8 cases of grade Ⅳ. The maximum dia,neter of the lesions was 2.1-8.2cm, （4.5 ± 0.2） em ill average. 2 eases of lesions were infratentorial ones and 34 cases were supratentorial ones. Most of the lesions were in frontal lobe and temporal lobe. There were visible lesions with unclear boundaries and diftuse abnormal signals in most of them; There was no edema around 19 cases and no significant mass effect. Only 12 cases were with mild to moderate cerebral edema and 5 cases were with lateral ventricle compression and midline structure translocation, T1WI sequence showed low signal and T2WI sequence showed high signal. CT scan showed that there were tumors with fuzzy boundaries and low density lesions. 17 cases had no obvious enhancement and 15 cases showed moderate enhancement, with visible nodules, small patchy or irregular ring enhancement. Conclusion Diffuse astrocytoma is common in young people. The imaging findings were particular. To adopt MRI and CT combined examination can achieve scan the multidimensional and multi- angle imaging scan. It is helpful for the differential diagnosis.