脑胶质细胞增生症的影像学特征分析  

Imaging features of gliosis

作　　者：王成[1] 费小瑞[1] 牛朝诗[1] 

机构地区：[1]安徽医科大学附属省立医院神经外科安徽省立体定向神经外科研究所,合肥230001

出　　处：《中国微侵袭神经外科杂志》2010年第2期65-67,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：安徽省科技攻关项目(编号:07010302202)

摘　　要：目的探讨脑胶质细胞增生症的影像学特征。方法回顾性分析经手术与病理证实的13例胶质细胞增生症病人的临床资料。病灶位于额叶5例,颞叶5例,丘脑2例,顶叶1例。术前均行CT、MRI平扫及增强,行水抑成像（FLAIR）检查3例,波谱成像（MRS）分析3例,弥散张量纤维束成像（DTT）1例。结果CT扫描病灶呈斑片状低密度影10例,混杂密度影伴钙化3例。MRI平扫病灶多呈片状或斑片状,边界不清,无明显水肿;增强后轻中度强化5例,无明显强化8例;3例行FLAIR检查均呈明显高信号;MRS分析示：胆碱（Cho）、肌酸（Cr）增高,N-乙酰天门冬氨酸（NAA）轻度下降。肿瘤全切除11例,立体定向活检2例。随访12例,时间6个月-9年;术后5年演变为胶质瘤1例。结论脑胶质细胞增生症无特征性CT及MRI表现,临床极易被误诊,综合分析CT、MRI,特别是MRI特殊序列影像特点,能显著提高诊断正确率。Objective To explore the imaging features of gliosis. Methods Clinical data of 13 patients with pathologically confirmed gliosis were analyzed retrospectively. The lesion was located in the frontal lobe in 5 patients, temporal lobe in 5, hypothalamus in 2 and parietal lobe in 1. CT and MR/scans and contrast-enhanced scan were performed in all the patients, fluid attenuated inversion recovery （FLAIR） in 3 patients, magnetic resonance spectroscopy （MRS）-based analysis in 3 and diffusion tensor tracking （DTT） in 1. Results CT scan showed low-density patches in 10 cases and mixed density with calcification shadow in 3. MRI results indicated that most of the lesions appeared to be flaky or patchy with unclear borders, but no significant edema, and mild-moderate enhancement was found in 5 cases and no significant enhancement in 8. FLAIR imaging of 3 patients all showed high intensity signal. MRS indicated increased choline and creatine contents and a slightly decreased N-aminosuccinic acid level. Total tumor resection was achieved in 11 cases and the other 2 underwent stereotactic biopsy. Twelve patients got a follow-up period ranged from 6 months to 9 years, gliosis in 1 patient evolved into glioma 5 years after the operation. Conclusions Gliosis has no typical clinical signals as well as imaging characteristics, easily to be misdiagnosed. Aggregate analysis of CT and MRI images, especially special MRI sequences can significantly improve the diagnostic accuracy rate.

关 键 词：神经胶质增生 磁共振成像 神经外科手术 

分 类 号：R742.89[医药卫生—神经病学与精神病学]