儿童颞叶节细胞胶质瘤的临床和MRI表现

目的:分析儿童颞叶节细胞胶质瘤的临床和MRI特点。方法:回顾性分析9例经手术及病理证实为颞叶节细胞胶质瘤的临床及MRI资料。结果:病灶均位于颞叶内侧,位置较表浅,形态各异,边界多不清,以轻度水肿为主,占位效应表现为无占位、轻中度占位效应。9例中囊实性7例,实性2例,其中有钙化者3例,钙化呈短T1短T2信号,囊性呈长T1长T2信号,实性呈等T1稍长T2信号,FLAIR呈稍高信号,DWI实性部分呈等信号,ADC图呈等或稍高信号,强化方式多样,5例表现为无强化,1例轻度强化,1例中度强化,2例明显强化。最小ADC均值(0.97±0.11)×10-3mm2/s,ASL呈高等低灌注,MRS表现为NAA峰下降,与对侧正常区相比,节细胞胶质瘤的NAA/Cr比值降低,Cho/Cr和Cho/NAA比值增加。结论:对于顽固性癫痫患儿,MRI发现颞叶较表浅部位异常征象应考虑节细胞胶质瘤的可能性,以早期诊断提供准确治疗方案。

Clinical and MRI features of temporal lobe ganglioglioma in children

Objective:To analyze the clinical and MRI features of temporal lobe ganglioglioma in children.Methods:The clinical and MRI imaging features of temporal lobe ganglioglioma in 9 patients confirmed by operation and histopathology examination were analyzed retrospectively.Results:The lesions were located in the medial temporal lobe,with different shapes and unclear boundaries,mainly with mild edema,no or mild to moderate occupying effect.Of the 9 cases,7 cases were cystic-solid,2 were solid,and 3 cases had calcification.Calcification showed T1-hyperintense and T2-hypointense;cystic components presented T1-hypointense and T2-hyperintense;solid lesion was observed as an iso-signal on T1WI and diffusion-weighted imaging(DWI),slightly high signal intensities(SI)on T2WI and T2 FLAIR,and iso-or slightly high SI on ADCmap.The enhancement patterns of the lesions were various.5 cases was not enhanced,one case mildly enhanced,one case moderately enhanced,and 2 cases obviously enhanced.The mean minimum ADC of the ganglioglioma was(0.97±0.11)×10-3mm2/s.ASL revealed a variety of perfusion patterns.Compared with the contralateral normal area,the MRS of the lesion area showed a decrease in NAA peak,NAA/Cr ratio,and an increase in Cho/Cr and Cho/NAA ratios.Conclusion:For the children with intractable epilepsy,the possibility of ganglioglioma should be considered when MRI reveals abnormal imaging findings in the superficial parts of the temporal lobe,which provides early diagnosis for accurate treatment.