CT增强扫描对脑星形细胞瘤的诊断价值  

Usefulness of enhanced CT scanning in the diangnosis of cerebral astrocytoma

作　　者：黄文光[1] 张卫东[1] 杜仲林[1] 

机构地区：[1]四川省广元市410医院,四川广元628017

出　　处：《实用医学影像杂志》2005年第5期243-245,共3页Journal of Practical Medical Imaging

摘　　要：目的总结分析脑星形细胞瘤的增强CT表现,以提高对该病的诊断与鉴别诊断能力。方法分析47例经手术病理证实的各级星形细胞瘤的CT平扫、增强表现及水肿特点并与病理进行对照。结果47例中,幕上43例,幕下4例,其中,Ⅰ级8例,Ⅱ级18例,Ⅲ级11例,Ⅳ级10例。平扫呈低密度或等低混杂密度,增强后Ⅰ级星形细胞瘤多无强化,水肿轻或无;Ⅱ级呈断续或连续环结节形强化或片团状强化居多,水肿程度不一;Ⅲ级～Ⅳ级多呈环结节型片团状伴囊变或厚壁花环状强化,且实体部分强化程度较Ⅰ级～Ⅱ级明显,水肿较重。结论增强扫描对脑星形胶质细胞瘤良恶性鉴别分级有重要参考意义。Objective To analyze the CT findings of cerebral astrocytoma without and with contrast enhancement and to elevate the diagnostic level. Methods Forty - seven patients with surgically and pathologically proved cerebral astrocytoma of different stages underwent CT scans before and after contrast enhancement. The CT findings of astrocytoma and the features of edema in all patients at CT plain scans and enhanced scans were analyzed and correlated with pathology. Results Among 47 cases, supratentorial and infratentorial astrocytoma was found in 43 and 4 cases, respectively. According to pathologic staging of astrocytoma, there were 8 cases of stage Ⅰ, 18 cases of stage Ⅱ, 11 cases of stage Ⅲ and 10 cases of stage Ⅳ in all patients. On CT plain scanning images, astrocytoma presented hypointense or mixed intense with isointense and hypointense. Following contrast enhancement stage Ⅰof astrocytoma was mostly non - enhanced while edema was light or absent, stage Ⅱ presented discontinued or continued ring - nodular or patchy - mass - form enhancement associated with different extent of edema, and stage Ⅲ and Ⅳpresented discontinued or continued pitchy - mass - form enhancement associated with cystic change or flower - circular enhancement with thick wall, simultaneously, the degrees of solid part enhancement and edema were higher than those or stage Ⅰ and Ⅱ. Conclusion Enhanced CT scanning has important reference value for staging of astrocytoma and differentiating between binegn and malignant astrocytoma.

关 键 词：星形细胞瘤 CT增强扫描 分级 

分 类 号：R739.4[医药卫生—肿瘤]