混合性胶质瘤的影像学表现

目的探讨混合性胶质瘤的影像学特征,提高诊断准确性. 资料与方法回顾分析48例经手术及病理证实的混合性胶质瘤的CT和/或MRI资料,并对少突-星形细胞混合性胶质瘤与纯少突胶质细胞瘤的病理及影像学资料进行比较. 结果 48例混合性胶质瘤中,少突-星形细胞混合性胶质瘤42例(少突-星形细胞瘤24例,间变性少突-星形细胞瘤18例);其他类型6例.少突-星形细胞瘤和间变性少突-星形细胞瘤均好发于大脑半球,以额叶最常见,其次为颞顶叶,偶见于幕下及脑室内.影像学上,脑叶肿瘤体积较大,常累及皮髓质,易向脑表面生长致脑回粗大肿胀.肿瘤可呈局限性或弥漫性,易囊变,钙化常见. 结论混合性胶质瘤中以少突-星形细胞混合性胶质瘤最常见(42/48,87.5%),其他类型均少见.少突-星形细胞混合性胶质瘤好发于额叶表浅部位,易钙化和囊变,与纯少突胶质细胞瘤的影像学表现近似,但结合患者一般资料、肿瘤发病率及影像学表现可作出倾向性诊断.

Imaging Findings of Mixed Gliomas

Objective To discuss the imaging features of mixed gliomas, to improve the diagnostic accuracy of the disease.Materials and Methods CT and/or MRI findings in 48 patients with pathologically proved mixed gliomas were retrospectively analyzed. The imaging signs and the pathological results were compared between oligo-astrocyte mixed gliomas and pure oligodendrogliomas.Results Of 48 mixed gliomas, oligo-astrocyte mixed glioma was seen in 42 (87.5%), including 24 oligo-astrocytomas and 18 anaplastic oligo-astrocytomas, while other mixed type was seen in 6. Oligo-astrocytomas and anaplastic oligo-astrocytomas occurred usually in cerebral hemisphere, with the frontal lobe being the most frequent site. The temporal and parietal lobes could be affected. Occasionally, the tumor occurred in the posterior fossa or in the ventricles. The tumors developed in cerebral hemisphere usually had a large volume, involving both gray and white matter and growing towards the surface of cortex causing swelling and thickening of the gyri. The tumor could be manifested as localized or diffused lesions, cystic degeneration was easy to occur, calcification of the tumor was a common finding.Conclusion In mixed gliomas, oligo-astrocyte mixed type is most common seen. It is difficult to differentiate oligo-astrocyte mixed gliomas with pure oligodendrogliomas as both of them have the similar imaging manifestations. However, a suggestive diagnosis can be made when both clinical data and imaging features are taken into account.