脑胶质肉瘤的影像学表现与临床病理对照  

Brain Gliosarcoma:Imaging Findings and Pathology

作　　者：彭泽华[1] 付凯[1] 陈加源[1] 蒋瑾[1] 白林[1] 熊焰[2] 董丹丹[2] 何远智[1] 李刚[1] 赵世煜[1] 

机构地区：[1]四川省人民医院放射科,四川成都610072 [2]四川省人民医院病理科,四川成都610072

出　　处：《实用放射学杂志》2006年第10期1173-1176,共4页Journal of Practical Radiology

摘　　要：目的探讨胶质肉瘤的影像学表现与临床病理特点。方法回顾性分析经手术病理证实的脑胶质肉瘤8例的CT、MR I表现和临床病理所见,并复习文献。结果7例位于幕上区,小脑1例,8例CT扫描5例为低等混杂密度,2例为低密度,1例为稍高密度,增强扫描为不规则强化,其内见囊变及坏死。3例行MR I检查,T1W I为低信号,T2W I为稍高混杂信号或高信号。增强扫描为不均匀强化,边界清楚,水肿明显。组织学检查,肿瘤由胶质母细胞和梭形细胞2种成分组成,免疫组化检查8例,脑胶质细胞成分GFAP为阳性,梭形细胞成分GFAP为阴性。结论脑胶质肉瘤少见,临床上无特异性,CT、MR I表现虽有一定特点,但确诊依靠病理检查。Objective To study the imaging and clincopathologic features of brain gliosarcoma. Methods Imaging findings and clincopathologic manifestations of brain gliosarcoma proved by operation and pathology in 8 cases were analysed with the review of literature. Resuits 7 cases were located in supratentorium and 1 was in the cerebellum. CT scan showed mixed hypo - and isodensity in 5 1 hypodensity in 2cases and hyperdensity in 1 case. On enhancement, the lesions appeared as an irregular pattern （ 7cases） with cystoid degeneration and necrosis. MRI were performed in 3 cases, which appeared as low signal on T1WI, and as high signal on T2WI. The enhanced MRI demonstrated the dramatically enhanced tumor in 3 cases ,irregular ring - like enhanced tumor in 2. Microscipically, all of the cases were conlposed of two kinds of cells,one was glioblastoma cell and the other was spindle cell . Immunohistochemically, GFAP marker in the glioblastoma cell was positive in 8 cases, but spindle cell was negative. Conclusion Brain gliosarcoma is rare clinically, it has no specific features. Although brain gliosarcoma has some relatively characteristic imaging findings, it is depended on pathologic examination to establish the diagnosis.

关 键 词：脑 胶质肉瘤 体层摄影术 X线计算机 磁共振成像 病理学 

分 类 号：R739.41[医药卫生—肿瘤] R814.42[医药卫生—临床医学]