三种累及视交叉和（或）视束的肿瘤MRI视束水肿样变的研究  

MR imaging study of edema-like change along optic tract in three kind of tumors involving the optic chiasma and/or optic tract

作　　者：张喜安[1] 漆松涛[1] 方陆雄[1] 潘军[1] 樊俊[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中华神经外科杂志》2009年第9期809-812,共4页Chinese Journal of Neurosurgery

基　　金：广东省医学科学技术研究基金（A2007391）

摘　　要：目的研究MRI视束水肿样变的诊断和治疗学意义。方法下丘脑视路胶质瘤19例、鞍上生殖细胞肿瘤13例、脊索瘤9例，均为初诊且肿瘤压迫视交叉和（或）视束，回顾性分析MRI上视束水肿样变的特点。结果视束水肿样变在下丘脑视路胶质瘤、鞍上生殖细胞肿瘤、脊索瘤的阳性率分别为36．8％、46．2％和0％，肿瘤大小及术前视觉功能障碍在视束水肿样变阳性和阴性患者间差异无统计学意义，视束水肿样变近2／3在术后早期即可消失或减轻。结论视束水肿样变不是颅咽管瘤的特征性表现，在手术满意切除肿瘤后，视束水肿样变多可消失或减轻，否则需考虑肿瘤视束内浸润或其他原因，特别是下丘脑视路胶质瘤。Objective To study the diagnostic and therapeutic significance of edema -like change along the optic tract. Method The pathology is hypothalamic -optic pathway glioma（HOG） in 19 cases, suprasellar germ cell tumor （ GCT ） in 13 cases, chordoma （ CHO ） in 9 cases. All patients were newly diagnosed and the tumors compressed the optic ehiasma and/or optic tract. The MRI radiological features were retrospectively analyzed. Results The positive ratio of edema - like change in HOG, GCT, CHO was 36. 8% ,46. 2% and 0% , respectively. The edema - like change was independent of tumor size as well as presence or absence of visual signs. The edema - like change in nearly 2/3 of the patients disappeared or reduced in early postoperative MRI follow up. Conclusions Edema- like change is not characteristic radiological feature of craniopharyngioma. After successful tumor removal, the edema - like change may disappear or reduce. If not, other reasons should be considered such as tumoral infiltration along the optic tract, especially in HOG.

关 键 词：神经胶质瘤 生殖细胞肿瘤 脊索瘤 磁共振成像 

分 类 号：R686[医药卫生—骨科学]