少突胶质细胞肿瘤临床和MR表现

目的 探讨少突胶质细胞肿瘤的MR表现特点及鉴别诊断.方法 回顾性分析34例经手术病理证实的少突胶质细胞肿瘤的临床和MR资料,包括肿瘤位置、信号、大小、强化表现和磁共振波谱(MRS)表现特点.结果 Ⅱ级少突胶质细胞瘤22例,Ⅲ级间变性少突胶质细胞瘤12例.肿瘤位于额叶22例,颞叶4例,同时累及额叶和颞叶7例,视交叉1例.25例肿瘤位置表浅.间变性少突胶质细胞瘤中囊变坏死11例,出血和钙化各3例.少突胶质细胞瘤中囊变坏死6例,出血2例,钙化8例.少突胶质细胞瘤肿瘤直径平均35 mm,间变性少突胶质细胞瘤肿瘤直径平均58 mm.11例间变性少突胶质细胞瘤呈显著不规则或环形强化, 6例少突胶质细胞瘤轻度强化,6例无强化,4例呈环形不规则轻到中度强化.6例间变性少突胶质细胞瘤行MRS检查,5例胆碱化合物/磷酸肌酸(Cho/Cr)>4,12例少突胶质细胞瘤行MRS检查,10例Cho/Cr在2.3~3.3之间,2例Cho/Cr<2.结论 位于额叶,靠近脑表面、累及皮层是少突胶质细胞肿瘤最主要的MR表现特点,显著不规则或环形强化、MRS检查Cho/Cr>4提示肿瘤为间变性.

Clinical and MR features of oligodendroglioma

Objective To study the MR features and differential diagnosis of oligodendroglioma.Methods Clinical and MR data of 34 pathology-diagnosed oligodendroglioma cases were analyzed retrospectively, which included tumor location,signal,size,enhanced and MRS features.Results 22 cases were diagnosed as WHOⅡoligodendroglioma and 12 cases WHOⅢ anaplastic oligodendroglioma.22 tumors located in the frontal lobes,4 tumors in the temporal lobes, 7 tumors in both frontal and temporal lobes,1 tumor located at the optic chiasma.25 tumors located in the superficial areas of the brain.For anaplastic oligodendrogliomas,tumor necrosis and cystic degenerations were showed in 11 cases,and hemorrhage or calcification in 6 cases.For oligodendroglioma,tumor necrosis and cystic degenerations were showed in 6 cases,hemorrhage in 2 cases,calcification in 8 cases.The average tumor diameter was 35 mm for oligodendroglioma and 58 mm for anaplastic oligodendroglioma.For anaplastic oligodendroglioma,obvious irregular or ring enhancements were showed in 11 cases.For oligodendroglioma, mild enhancement was showed in 6 cases,no enhancement in 6 cases and mild or moderate irregular ring-type enhancements in 4 cases.MRS was performed in 6 anaplastic oligodendrogliomas the Cho/Cr ratio was over 4 in 5 cases.MRS was performed in 12 oligodendrogliomas the Cho/Cr ratio was between 2.3 to 3.3 in 10 cases and below 2 in 2 cases.Conclusion The main MR feature of anaplastic oligodendroglioma is that tumor is located in the frontal lobe and superficial area of the brainwith irregular or ring-type enhancement,and the Cho/Cr ratio over 4.