少突胶质肿瘤MRI增强与肿瘤分级的相关性分析  

Oligodendroglial Tumors:The Correlation between Tumor Grades and Tumor MRI Enhancement

作　　者：刘权[1] 彭卫军[1] 周正荣[1] Danielle Baleriaux 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科、复旦大学上海医学院肿瘤学系,上海200032 [2]比利时自由大学附属Erasme医院神经放射科

出　　处：《放射学实践》2009年第2期124-127,共4页Radiologic Practice

摘　　要：目的:探讨颅内少突胶质瘤的MRI增强表现,分析肿瘤强化与肿瘤分级的相关性。方法:回顾性分析30例31个病理证实的颅内少突胶质肿瘤的MRI资料,观察病变强化程度、强化方式,测定肿瘤增强率并与肿瘤分级及亚型作对照研究。结果:31个颅内少突胶质肿瘤,24个为单纯型(OD),其中分化好的(Ⅱ级)15个,间变型(Ⅲ级)9个;7个为混合型(OA),其中Ⅱ级3个,Ⅲ级4个。平均肿瘤增强比(CER)分别为Ⅱ级OD:1.11±0.11,Ⅱ级OA:1.37±0.31,Ⅲ级OD:1.65±0.18,Ⅲ级OA:2.16±0.32,与肿瘤分级及恶性程度呈正相关(P=0.000),在两种级别肿瘤中差异有显著性意义(P=0.002)。当分界值为CER=1.30时,判断肿瘤级别的敏感度为85%,特异度78%。三种强化方式见于19个有增强的肿瘤(Ⅲ级对Ⅱ级分别为11/13vs8/18):均匀点状结节样强化(7/13vs7/18)、环形强化(9/13vs2/18)、大块强化(2/13vs0)。结论:MRI肿瘤增强更多见于高级别少突胶质肿瘤,平均肿瘤强化比依Ⅱ级OD,Ⅱ级OA,Ⅲ级OD,Ⅲ级OA的顺序呈上升趋势。点状、结节状强化是该肿瘤的特征性强化方式之一,环形强化的出现预示肿瘤高级别可能。Objective： To evaluate the correlation between tumor grades and tumor enhancement in oligodendroglial tumors. Methods：Findings from 31 surgical pathologically proved oligodendroglial tumors in 30 patients were retrospectively analyzed and compared. Contrast enhanced ratios （CERs） were measured; Mean CERs were compared between both the grades and among the subtypes. Enhancement patterns were also observed. Results：The 31 tumors include 24 pure oligodendrogliomas （9 grade Ⅲ ,15 grade Ⅱ ） and 7 mixed oligoastrocytomas （4 grade Ⅲ,3 grade Ⅱ ）. Mean CERs were 1. 11± 0.11 for OD grade Ⅱ ,1.37Ⅱ0.31 for OA grade Ⅱ ,1.65±0.18 for OD grade Ⅲ and 2.16±0.32 for OA grade Ⅲ. Positive correlation was observed between CERs and tumor subtypes （P= 0. 000）, statistical difference was noted between the two grades （P=0. 002）. The cutoff value of CER= 1.30 gives the sensitivity 85% ,specificity 78% for differentiation of the two grades. 3 enhancement patterns were observed in 19 of the 31 tumors （grade Ⅲ vs grade Ⅱ：11/13 vs 8/18）：dot-and nodular-like enhancement （grade Ⅲ vs grade Ⅱ ：7/13 vs 7/18）,ring enhancement （9/13 vs 2/18）,bulk enhancement （2/13 vs 0）. Conclusion：Tumor enhancement was more common in high grade oligodendroglial tumors. An upward tendency was not- ed of mean CERs in order of OD grade H ,OA grade II ,OD grade Ⅲ ,OA grade Ⅲ. Nodular-like enhancement was characteristic of oligodendroglial tumors. Ring enhancement may indicate high grade of the tumor.

关 键 词：少突胶质肿瘤 肿瘤分级 造影增强 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]