脑胶质瘤并出血与单纯性脑出血的磁共振成像诊断及鉴别诊断

MRI diagnosis and differential diagnosis of brain glioma with hemorrhage and simple cerebral hemorrhage

目的探讨颅内胶质瘤并出血的磁共振成像(MRI)诊断及与单纯性脑出血的鉴别诊断。方法回顾性分析10例脑胶质瘤并出血及15例单纯性脑出血患者的MRI图像,并分析其影像特征。结果10例胶质瘤并出血患者,右侧颞叶3例、右侧顶叶2例、右侧额叶1例,左侧颞叶2例,左侧顶枕叶2例;T1WI呈混杂、短T1信号,T2WI、T2flair呈混杂高信号,DWI呈低信号,内见部分高信号扩散受限;瘤周水肿明显8例,稍明显2例;占位效应明显9例,不明显1例;增强扫描可见有部分实性成分强化;15例单纯性脑出血,右侧额叶2例,右侧顶叶2例,左侧颞顶叶交界区2例,右侧基底节区5例,左侧基底节区4例;T1WI见短T1信号,内部见低信号;T2WI、T2flair呈混杂高信号,内部见稍低信号;弥散加权成像(DWI)呈混杂高信号;病变周围水肿不明显;占位效应不明显。结论颅内脑胶质瘤并出血及单纯性脑出血具有较特征性表现,MRI能较好地显示病变的生物学特性,有助于鉴别诊断及指导制定治疗方案。

Objective To explore the diagnostic value and differential diagnosis of brain glioma with hemorrhage and simple cerebral hemorrhage.Methods Retrospective analysis of 10 cases of glioma with hemorrhage and 15 cases of simple cerebral hemorrhage characteristics in clinical diagnosis.Results Among 10 cases of glioma with hemorrhage,there were 3 cases of right temporal lobe,2 cases of right parietal lobe,1 case of right frontal lobe,2 cases of left temporal lobe and 2 cases of left parietal occipital lobe.T1WI presented mixed and short T1 signals,T2WI and T2flair showed mixed high signals,DWI presented low signal,and some high signal diffusion was limited.There were 8 cases with obvious peritumoral edema,and 2 cases with slightly edema.There were 9 cases with obvious space effect,and 1 case without obvious.Enhanced scanning showed partial strengthening of solid components.There were 15 cases of simple cerebral hemorrhage,there were 2 cases of right frontal lobe,2 cases of right parietal lobe,2 cases of left temporal parietal junction,5 cases of right basal ganglia and 4 cases of left basal ganglia.T1WI showed short T1 signals,low internal signal;T2WI and T2flair showed mixed high signals,see lower signal inside;DWI presented mix high signals.The edema around the lesion was not obvious,the placeholder effect is not obvious.Conclusion Intracranial glioma with hemorrhage and simple cerebral hemorrhage has relatively characteristic,MRI can better display the biological characteristics of the lesions and help guide the formulation of treatment plans.