颅内胶质肉瘤的CT与MRI表现

目的 探讨颅内胶质肉瘤的临床表现及影像学特征。方法 回顾性分析15例经手术病理证实的胶质肉瘤影像资料。结果 肿瘤均位于幕上，其中颞顶区13例，枕叶1例，丘脑1例。形态为圆形或类圆形。病灶直径为3.0-9.0cm(平均4.6cm)。CT扫描7例为低等混杂密度，4例为低密度，CT值18－22HU，4例为略高密度，CT值48－55HU。增强扫描呈不规则强化。边界清晰，周围有水种。6例行MRI检查，T1WI呈不规则长T 1低信号，T2WI呈稍高信号，强化后呈不均匀实质性增强。结论 颅内胶质肉瘤术前定性诊断困难。CT、MRI表现结合临床可做出倾向性诊断。增强检查有利于与胶质母细胞瘤鉴别。

CT and MRI manifestations of intracranial gliosarcoma

Objective To investigate the clinical and characteristic imaging findings of intracranial gliosarcoma. Methods The imaging findings of surgery and pathology proved intracranial gliosarcoma in 15 cases were retrospectively analyzed. There were 10 males and 5 females, ranging in age from 44 to 67 years (mean age 58 years). Results All tumors were located in supratentorium, including 13 cases in the temporal or parietal lobe, 1 cases in the occipital lobe, and 1 cases in the thalamus. Tumors appeared as round or ellipse in shape. The lesions ranged in size from 3 to 9 cm (mean 4.6 cm). CT scan showed mingled hypo and isodensity in 7, hypodense in 4 with CT value from 18 to 22 HU, hyperdense in 4 with the CT value from 48 to 55 HU. Enhancement appeared as an irregular pattern. The margin was clear. Most intracranial gliosarcoma showed perifocal edema. MRI were examined in 6 cases, whichappeared as low signal on T 1WI, and as high signal on T 2WI. There was irregular enhancement of the mass. Conclusion It was difficult to make the correct preoperative diagnosis for gliosarcoma, but it was possible to make a tendency diagnosis using CT or MR combined with the history. Contrast enhanced CT and MRI should be useful in differentiating gliosarcoma from glioblastoma.