颅内节细胞胶质瘤的MRI表现与病理分析

MRI findings and pathological analysis of intracranial ganglioglioma

目的分析颅内节细胞胶质瘤的MRI表现及病理特点,提高对节细胞胶质瘤的认识。方法对南京总医院2009年1月至2016年10月收治的19例经手术病理证实的节细胞胶质瘤的MRI表现及病理分型进行分析。结果病变位于颞叶10例,额叶3例,顶叶、枕叶及侧脑室、小脑各1例,侵及两个脑叶以上的2例,其中15例病灶位于皮层及皮层下。病灶呈囊性5例,囊实性7例,实性7例;9例瘤周无水肿、7例轻度水肿,3例中度水肿。增强扫描,囊性病灶1例囊壁明显强化,4例无强化;囊实性病灶内壁结节均明显强化,囊性成分无强化;7例实性病灶1例呈小片状明显强化,3例边缘或小片状轻度强化,3例无强化。3例行CT平扫,1例见点状钙化。3例实性病灶加扫MRS,MRS肿瘤实性成分cho升高,NAA降低。19例GG病理分型WHOⅠ级5例,WHOⅡ级13例,WHOⅢ级1例。结论节细胞胶质瘤影像学表现多样,但仍具有一定的特征性,结合MRS对节细胞胶质瘤的诊断及鉴别诊断具有重要价值,可为临床提供术前信息。

Objective To improve the understanding of ganglioglioma through analyzing the magnetic reso-nance imaging （MRI） and pathological features of intracranial ganglioglioma. Methods The MRI features and patho-logical characteristics of 19 patients with surgically and pathologically verified ganglioglioma, who admitted to NanjingGeneral Hospital of Nanjing Military Command from January 2009 to October 2016, were analyzed. Results Therewere 10 cases of lesions in the parietal lobe, 3 cases in the front of lobe, 1 case in the parietal lobe, occipital lobe, cerebel-lum and lateral ventricle respectively, and 2 cases involving two lobes. Among the 19 cases, 15 cases of lesions were un-der the cortex. The lesions were cystic in 5 cases, cystic solid in 7 cases, and solid in 7 cases. Nine cases had no edema inthe tumors, 7 cases had mild edema and 3 cases had moderate edema. After enhanced scan, the cystic wall was enhancedapparently in one of the five cystic lesions, and the other four were not. The tubercles in inner wall of all the cystic solidlesions were enhanced apparently and the cystic contents were not. In the 7 solid cases, the lesions showed patch en-hancement in one case, mild patch enhancement in 3 cases and no enhancement in 3 cases. One case showed calcifica-tion spots in CT plain scan. After the 3 cases of solid lesion were MRS scanned, the solid tumor component cho increased and the NAA decreased. According to GG pathological type, there were 5 cases of WHO grade I, 13 cases of grade II and 1 case of grade III. Conclusion The imaging manifestations of the ganglioglioma are diverse but still have certain characteristics. The MR/features, combined with MRS, may show great value in diagnosis and antidiastole, and provide preoperative information for clinical practice.