成人及青少年颅内弥漫性中线胶质瘤伴H3K27M突变的影像学特征研究

Brain MRI Features of Diffuse Midline Gliomas with H3K27M Alteration in Teenagers and Adul Patients

目的 研究成人及青少年颅内弥漫性胶质瘤伴H3K27M突变的多模态MRI征象。方法 回顾性收集成人及青少年颅内弥漫性中线胶质瘤伴H3K27M突变83例患者的临床资料及影像学资料。由2名影像学医生独立阅片,对MRI所示直接征象及间接征象进行定性及半定量分析。分别对以上征象依据H3K27M突变状态及中线肿瘤发生部位进行组间比较及组内分层分析。结果 H3K27M突变型颅内中线胶质瘤好发于年轻人群。肿瘤处于丘脑和脑干等中线部位,发生位置与年龄相关。MRI增强扫描后肿瘤表现为薄壁强化、结节状强化,T2-FLAIR增强有助于该病鉴别;瘤周水肿以轻中度为主,易引起梗阻性脑积水。结论 H3K27M突变型颅内弥漫中线胶质瘤具有特异性影像学特征,识别该类肿瘤影像学特征有助于在术前为临床诊疗提供依据。

Aim To study the multimodal MRI features of diffuse glioma with H3K27M mutation in adults and teenagers.Methods The clinical data and imaging data of 83 cases of diffuse midline glioma with H3K27M mutation in adults and adolescents were collected retrospectively.Two neuroradiologists evaluated the images independently,and MRI features were analyzed qualitatively and semi-quantitatively.According to H3K27M mutation status and midline tumor location,the above signs were compared between the groups and stratified within the groups.Results H3K27M mutant midline gliomas mainly occur in young individuals.The tumors were often located in the thalamus and brainstem,and the location was related to age.The tumors often showed thin-walled enhancement and nodular enhancement after enhancement.T2-Flair enhancement was helpful to differentiate the disease.The peritumoral edema was mainly mild to moderate,and it is easy to cause obstructive hydrocephalus.Conclusion H3K27M mutant diffuse midline glioma has specific imaging features,and the identification of imaging features of this type of tumor is helpful to provide evidence for clinical diagnosis and treatment before surgery.