颅内原发胶质肉瘤的MRI影像表现

目的分析颅内胶质肉瘤的MRI影像特征,以及这些影像特征在与颅内其他常见原发肿瘤鉴别诊断中的意义。资料与方法回顾性分析本院1998年4月至2011年4月9例经病理证实的胶质肉瘤患者的MRI影像表现、病理结果及临床表现。患者年龄30～66岁,平均48岁,所有患者均经手术切除及病理证实。9例患者均行常规T1WI、T2WI及增强扫描,部分患者行液体衰减反转恢复(FLAIR)、扩散加权成像(DWI)、扩散张量成像(DTI)及扩散张量纤维束成像(DTT)扫描。结果本组9例胶质肉瘤均发生在幕上。MRI平扫,肿瘤表现为边界清楚、均匀性或囊实性占位,伴有中重度水肿。T1WI上多呈低信号,T2WI上多呈高信号,FLAIR图像上,4例表现为高信号。增强扫描,多为明显环形强化。结论胶质肉瘤影像学表现具有一定特征,MRI能清晰显示病变,但与颅内其他原发肿瘤鉴别较困难,多序列成像有助于其鉴别诊断及预后的估计,确诊仍需病理检查。

MR Diagnosis of Primary Cerebral Gliosarcoma

Objective To investigate MR imaging features of gliosarcomas,and its significance in differential diagnosis of gliosarcoma.Materials and Methods MRI findings,pathological results and clinical information of nine patients with gliosarcomas were retrospectively analyzed.All patients had received surgical resection.Nine patients received conventional MR examination,FLAIR,DWI,DTI and DTT sequences were also available in some patients.Results All the tumors were located at supratentoria.The tumors were well demarcated with homogeneous or cystic appearance and moderate to extensive surrounding edema,most gliosarcomas were hypointensity on T1W,and hyperintensity on T2W.Four lesions were hyperintensity on FLAIR.Most tumors were markedly heterogeneous ring-like enhanced.Conclusion Gliosarcomas have certain characteristic MR features,MRI features are helpful to the differential diagnosis of gliosarcomas and evaluate prognosis of tumors.