下视丘胶质瘤的影像诊断

Imaging Diagnosis of Optic-hypothalamic Gliomas

目的 研究下视丘胶质瘤的影像表现及临床发病特征。资料与方法 回顾性分析 4 8例经手术病理证实的下视丘胶质瘤患者的影像及临床资料。其中男 30例 ,女 18例 ,年龄 0 .5～ 39岁 ,平均 9.2岁。 4 8例患者中 12例CT平扫 ,2 0例MRI平扫 ,2 8例MRI平扫和增强。结果 4 8例患者 ,临床主要表现为头痛、恶心呕吐、视力障碍等颅高压及视神经受损的症状。CT平扫病变表现为鞍上分叶状肿块 ,多呈等、低密度或等低混杂密度 ,瘤内出血及钙化少见。MRI平扫 ,T1WI上多表现为等、低信号或等低混杂信号 ,T2 WI上大多表现为高或等高混杂信号。增强扫描 ,肿瘤实性部分可见明显均匀强化。结论 下视丘胶质瘤的影像及临床表现有一定的特征性 ,在多数情况下可以作出正确的术前诊断 。

Objective To study the imaging and clinical features of optic-hypothalamic gliomas.Materials and Methods The imaging findings and the clinical data of 48 patients (30 males and 18 females, ages 0.5～39 with a mean of 9.2) with pathologically-proved optic-hypothalamic gliomas were retrospectively analyzed. Plain MR scanning was performed in 20 cases, while both plain and enhanced MR scanning in 28 cases. Additional CT scanning was carried out in 12 cases.Results Clinical manifestations included headache, nausea, vomiting and visual disturbance, etc. On plain axial CT scans, the lesion presented as a suprasellar lobulated mass with iso-, or low-, or mixed-density, rarely with hemorrhage or calcification. On plain MRI, the lesion was manifested as iso-, hypo-, or iso/hypo mixed-signal on T 1WI, while hyper-, or iso/hyper mixed-signal on T 2WI. The solid content of the tumor showed marked homogeneous enhancement after contrast injection.Conclusion Optic- hypothalamic gliomas carry certain imaging and clinical features, which are very helpful for making a correct preoperative diagnosis and for selecting proper therapy.