MRI增强扫描在评估颅脑胶质瘤手术患者预后的临床价值

目的探讨MRI增强扫描对颅脑胶质瘤手术患者预后的评估价值。方法以我院2014年1月-2015年4月收治的30例颅脑胶质瘤患者为研究对象,均经手术病理证实,术前、术后定期行MRI增强扫描,观察术后MRI表现。结果术后3d内MRI复查提示反应性强化4例,多表现为均匀环状或片状强化;肿瘤残余6例,多为不规则形态,肿瘤边缘结节或团状强化。肿瘤复发9例(其中术后3个月复发1例,6-18个月复发8例),MRI显示术区或术区周围出现新病灶,增强扫描不规则花环状或结节样强化。术后1~3个月复查误诊6例(将反应性强化误诊为肿瘤残余5例、肿瘤复发1例)。结论术后3d内行MRI增强扫描对肿瘤术后切除程度(肿瘤残余)准确显示,对后续治疗方案制定、预后评估具有十分重要意义。

Clinical Value of Enhanced MRI Scan in Evaluating the Prognosis of Patients Having Craniocerebral Glioma Surgery

Objective To explore the evaluation value of enhanced MRI scan in the prognosis of patients having intracranial glioma surgery.Methods 30 cases of patients with intracranial gliomas treated in our hospital from January 2014 to April 2015 were taken as the research objects. All of the patients were confirmed by surgery and pathology. Enhanced MRI scan was performed regularly before and after operation. The MRI findings were observed.Results In postoperative 3d, MRI reexamination indicated reactional enhancement in 4 cases, most of which manifested as homogeneous and ring or sheet enhancement, tumor residual in 6 cases with irregular shape, nodules or mass enhancement on tumor edge. Tumor recurrence occurred in 9 cases (a cases of recurrence in postoperative 3 months, 8 cases in 6 to 18 months). MRI showed new lesions in the operation area or around the operation area. Enhanced scan indicated irregular garland-like or nodule enhancement. In postoperative 1 to 3 months, postoperative misdiagnosed 6 cases (5 cases of reactional enhancement misdiagnosed as tumor residual and a case of tumor recurrence).Conclusion Enhanced MRI scan performed in postoperative 3d is of very important significance in accurately displaying the resection degree (tumor residual) after tumor surgery, formulating following therapy plan and evaluating the prognosis of the patients.