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颅内神经节细胞胶质瘤的临床、病理 及MRI表现分析

作者:万红艳

所属单位:湖北省枝江市人民医院影像科 (湖北 枝江 443200)

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摘要

目的 分析颅内神经节细胞胶质 瘤的临床、病理及MRI表现。方法 收集 我院经病理确诊颅内神经节细胞胶质25 例,分析病灶部位、数量、平扫及增强信 号特点、瘤周水肿情况,以探析MRI影像 特点。结果 25例患者中,22例为癫痫发 作,其中19例以癫痫为唯一临床表现、3 例为失神发作。2例为囊性、10例为囊实 性、13例为实性。T1WI上囊性患者以低信 号为主,实性患者以等信号或稍低信号为 主,囊实性患者两类信号兼有。T2WI上囊 性患者以高信号为主,实性患者为等信号 或稍高信号,囊实性患者两类信号兼有。 增强扫描囊性患者无强化,实性患者以 轻度强化为主,囊实性患者以明显强化 及轻度强化为主。1例无水肿、15例轻度 水肿、4例中度水肿、5例重度水肿。结 论 颅内神经节细胞胶质瘤多以癫痫发作 为主,可分为囊性、囊实性及实性3种类 型,不同类型患者具有不同MRI表现,结 合病理特点可为临床诊治提供指导。

Objective To analyze the clinical, pathological and MRI findings of intracranial ganglioglioma. Methods 25 patients with intracranial ganglioglioma confirmed by pathology in our hospital were selected as the research object. The location, quantity, signal characteristics of plain scan and enhanced scan and peritumoral edema were analyzed to explore the MRI imaging findings. Results In the 25 patients, there were 22 cases with epilepsy seizures, including 19 cases whose only clinical manifestation was epilepsy and 3 cases was absence seizures. There were 2 cases with cystic lesions, 10 cases with cystic solid ones and 13 cases solid ones. Patients with cystic lesions mainly showed low signal on T1WI while patients with solid ones mainly showed equal signal or slightly low signal and patients with cystic solid ones showed both two types of signals. Patients with cystic lesions mainly showed high signal on T2WI while patients with solid ones mainly showed equal signal or slightly high signal and patients with cystic solid ones showed both two types of signals. Enhanced scan showed there was no enhancement in patients with cystic or solid lesions and there was mild enhancement in patients with solid ones and obvious enhancement and mild enhancement in patients with cystic and solid ones. There were 1 case without edema, 15 cases with mild edema, 4 cases with moderate edema and 5 cases with severe edema. Conclusion The main manifestation of intracranial gangliogliomas is epilepsy seizure, which can be divided into cystic, cystic solid and solid of 3 types. Different types of patients have different MRI findings. Combined with pathological features, it can provide guidance for clinical diagnosis and treatment.

【关键词】颅内神经节细胞胶质瘤;临床 表现;MRI;DWI

【中图分类号】R739.41

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.02.004

前言

颅内神经节细胞胶质瘤为神经元和胶质细胞成分共同构成的新生 肿物,在中枢神经系统肿瘤中所占比例在0.4%~4%,为颅内少见神经 系统肿瘤[1]。2007年WHO将其归入I或Ⅱ级,属良性,手术治疗可取得 较好预后[2],因而尽早实现临床确诊极为关键。本文以我院颅内神经 节细胞胶质瘤患者为例,对颅内神经节细胞胶质瘤的临床、病理及MRI 表现进行分析,现报道如下。