脑胶质肉瘤的MRI表现及临床病理对照研究

目的 评价MRI对脑胶质肉瘤的诊断价值. 资料与方法 经病理证实的脑胶质肉瘤8例,回顾分析其MRI表现及病理学表现. 结果 病灶基本上表现为长T1 、长T2信号,边界不清,多数形态不规则,伴有囊变和坏死,个别可见瘤内出血,生长具有侵袭性,少数为结节状.周围脑组织水肿较轻,占位效应明显.增强扫描7例明显强化,1例轻中度强化,5例呈不规则环状强化,2例呈结节状强化,3例内部可见丝瓜瓤样不规则条状强化;2例直接侵犯邻近脑叶,3例发现瘤内出血,5例发生于脑凸面,1例发生于深部脑白质,1例发生于左侧侧脑室. 结论 脑胶质肉瘤通常发生于额、顶叶脑凸面,MRI能够清楚地显示病变及其边界,但信号改变易与多形胶质母细胞瘤、恶性胶质瘤、转移瘤等相混淆.确诊仍依赖于组织病理学诊断.

Gliosarcoma:MRI Findings and Clinical Pathology Correlation

Objective To evaluate the MRI diagnostic value of brain gliosarcoma. Materials and Methods Review eight cases of brain gliosarcoma confirmed pathologically and to analyze the performance of their MRI and pathological findings. Results The fundamental performance of glisarcoma were long T1 and long T2 signal,unclear border,the majority of irregular shapes, associated with cystic degeneration and necrosis.Individual tumors had internal bleeding.All the tumors had an aggressive growth;Minorities nodular.Perifocal edema was light or moderate,but mass effect was obviously.After enhancement,seven cases were significantly enhanced,one case were mild to moderate strengthening,five cases were irregular ring-like enhancement,two cases were nodular enhancement and three cases were internal irregular strips strengthened.Three cases had tumor hemorrhage.Two cases directly infiltrated to adjacent brain lobes.Five cases occurred in the brain convex surface,one in the deep white matter and one in the left lateral ventricle. Conclusion Gliosarcoma usually occurs in the frontal,parietal brain surface.MRI can clearly demonstrate lesions and the border,but the signals are easy to be confused with glioblastoma,malignant gliomas,metastases and so on.The final diagnosis still dependents on histopathology.