囊性少突胶质细胞瘤与多形性黄色星形细胞瘤影像征象对比分析

目的对比囊性少突胶质细胞瘤(cystic oligodendroglioma,COD)与多形性黄色星形细胞瘤(pleomorphic xanthoastrocytoma,PXA)的磁共振成像(magnetic resonance imaging,MRI)征象差异,以对二者做出鉴别诊断。材料与方法回顾性分析经手术病理证实的15例COD患者与9例PXA患者的术前MRI平扫、增强扫描及扩散加权成像(diffusion-weighted imaging,DWI)检查的影像资料,对其12项MRI征象及年龄进行对比分析。计数资料组间比较采用卡方检验,计量资料组间比较采用独立样本t检验或非参数检验。结果 15例COD与9例PXA相比,肿瘤大小(t=4.824,P0.01)、肿瘤形态(χ~2=13.211,P0.01)、肿瘤实性结节的位置(χ~2=13.211,P0.01)、实性结节强化的均匀性(χ~2=9.802,P0.01)、囊壁的强化程度(χ~2=10.959,P0.01)这5项影像学征象差异有统计学意义,肿瘤位置(χ~2=3.8 9 8,P0.0 5)、与软脑膜的关系(χ~2=0.059,P0.05)、实性结节T2WI信号(χ~2=0.336,P0.05)、实性结节DWI信号(χ~2=0.059,P0.05)、囊壁光整性(χ~2=0.320,P0.05)、与周围脑组织的关系(χ~2=0.800,P0.05)、瘤周水肿程度(χ~2=0.572,P0.05)这7项影像学征象差异无统计学意义(P0.05),年龄差异无统计学意义(Z=-1.717,P0.05)。结论颅内COD与PXA在肿瘤大小、肿瘤形态、实性结节的位置及强化的均匀性、囊壁强化程度这5项MRI征象差异有统计学意义,可以作为二者鉴别诊断的影像学依据,肿瘤好发位置及好发年龄亦可作为鉴别诊断的辅助指标。

Comparative analysis imaging manifestations between cystic oligodendroglioma and pleomorphic xanthoastrocytoma

Objective: Comparison of the different MRI findings between the cystic oligodendroglioma (COD) and pleomorphic xanthoastrocytoma (PXA) to make a differential diagnosis. Materials and Methods: The MRI imaging data of 15 cases of COD and 9 cases of PXA confirmed by pathology were retrospectively analyzed and compared the differences of age and 10 MRI findings of two tumors. The chi-square test was used to compare the counting data. The independent sample t test and non-parametric test was used to compare the measurement data. Results: Differences in tumor size (t=4.824, P<0.01), tumor shape (χ2=13.211, P<0.01), the location of the mural nodule (χ2=13.211, P<0.01), homogenous enhancement of the mural nodule (χ2=9.802, P<0.01) and the enhancement degree of cystic wall (χ2=10.959, P<0.01) between COD and PXA were statistically significant. Differences in tumor location (χ2=3.898, P>0.05), the division of the pia mater (χ2=0.059, P>0.05), T2WI signal of the mural nodule (χ2=0.336, P>0.05), DWI signal of the mural nodule (χ2=0.059, P>0.05), the smoothness of cystic wall (χ2=0.320, P>0.05), relationship with adjacent brain (χ2=0.800, P>0.05) and peritumoral edema (χ2=0.572, P>0.05) were not statistically significant. And the predilection age difference was not statistically significant either (Z=-1.717, P<0.05). Conclusion: The MRI findings in tumor size, tumor shape, the location of the mural nodule, homogeneous enhancement of the mural nodule and the enhancement degree of cystic wall are helpful in the differential diagnosis between COD and PXA. The tumor location and the predilection age can be used as a supplementary indicator of differential diagnosis.