儿童胶质母细胞瘤的CT/MRI影像学特征

CT/MRI features of glioblastoma in children

目的探讨儿童胶质母细胞瘤CT/MRI的影像学特征,提高其术前诊断的准确性。方法选取19例1~13岁经手术病理证实为胶质母细胞瘤的影像学资料,结合文献进行回顾性分析。结果病灶位于额颞顶叶8例,脑干4例,脑室4例,丘脑2例,小脑1例。胶质母细胞瘤中11例无明显水肿(57.89%),6例表现为重度水肿,12例伴有囊变坏死(63.16%),CT平扫肿瘤呈等或稍高密度,伴出血时呈明显高密度影,MRI实性成分在T1WI呈低信号、T2WI呈高信号,增强扫描大部分呈明显不规则强化,2例位于脑干病灶未见明显强化,14例DWI呈高信号。术后随访,3例1年内死亡,6例短期内复发。结论胶质母细胞瘤在儿童少见,影像学表现有一定的特征性,结合肿瘤的发病部位、水肿情况以及囊变等特点,有助于该病的术前准确诊断。

Objective To investigate the imaging features of glioblastoma in children,and to improve the diagnostic accuracy.Methods The imaging data of 19 cases of glioblastoma confirmed by operation and pathology were analyzed retrospectively,and literature review was performed.Results The lesions were located in frontotemporal lobe(8 cases),brainstem(4 cases),ventricle(4 cases),thalamus(2 cases)and cerebellum(1 case).Among the glioblastomas,11 cases had no obvious edema(57.89%),6 cases showed severe edema,and 12 cases had cystic necrosis(63.16%).On CT,the tumors showed equal or slightly high density,and obvious high density when accompanied with hemorrhage.On MRI,the solid components showed low signal intensity on T1WI and high signal intensity on T2WI,and most of them showed obvious irregular enhancement after enhancement.2 cases located in brainstem had no obvious enhancement.14 cases showed hyperintense on DWI images.During the follow-up,3 cases died within 1 year and 6 cases recurred in a short time.Conclusion Glioblastoma is rare in children and has certain imaging characteristics.Combined with the characteristics of tumor location,edema and cystic,it is helpful for the accurate diagnosis before operation.