颞叶致痫脑肿瘤的MRI影像分析  

MRI analysis of temporal lobe epileptogenic tumors

作　　者：杜铁桥[1,2] 朱明旺[1,2] 赵殿江[1,2] 王丽宁[1,2] 张旭飞[1,2] 

机构地区：[1]首都医科大学第十一临床医学院 [2]北京三博脑科医院放射科,北京100093

出　　处：《磁共振成像》2013年第1期13-17,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的观察和分析颞叶致痫脑肿瘤患者的临床、肿瘤病理类型和MRI表现。材料与方法回顾性分析39例颞叶致痫肿瘤的发病年龄、病程与癫痫类型等临床资料、MRI表现、累及部位及病理类型。结果 39例颞叶肿瘤患者的癫痫发病年龄平均9.4岁,36例(92.3%)为儿童期起病;平均癫痫病程98.8个月。以复杂部分性发作居多,共29例(74.4%),其中11例伴全身性强直-震挛发作(GTCS),2例伴失神发作;GTCS和强直性发作分别为5例(12.8%)和2例(5.1%);单纯部分性发作3例(7.7%)。颞叶肿瘤病理类型:节细胞胶质瘤24例(61.5%),星形细胞瘤5例(12.8%),少枝胶质细胞瘤和发育不良性神经上皮瘤各3例(7.7%),其他类型肿瘤4例(10.3%)。肿瘤位于颞叶内侧和外侧分别为28例和11例;颞叶内侧肿瘤累及海马者(71.4%)显著高于颞叶外侧肿瘤(9.1%)。MRI确定病灶为囊实性、实性为主和囊性为主者分别占46.2%、30.8%和23.1%;MRI增强扫描64.1%的病灶无强化。除胚胎发育不良性神经上皮瘤(DNET)位于皮层内,具有多小囊性特征外,其他各类肿瘤MRI表现缺少特异性。结论颞叶肿瘤性癫痫好发于儿童期,多为累及颞叶内侧或外侧皮层,且为生长缓慢的小肿瘤,其中尤以节细胞胶质瘤居多。癫痫发作类型以复杂部分性发作伴有或不伴有全身强直震挛发作最为常见。Objective： To observe and analyze relationship among clinical, MRI findings and pathological types of the temporal lobe epileptogenic tumors. Materials and Methods： We retrospectively analyzed clinical data of 39 cases with temporal lobe epileptogenic tumor including age of onset, duration and seizure type of epilepsy, MRI features and pathological type of these tumors. Results： The average onset age of the temporal lobe epilepsy was 9.4 years and 36 patients （92.3%） was under 18 years old. An average epilepsy course was 98.8 months. There were 29 cases （74.4%） with complex partial seizures in the group, including 11 cases （28.2%） associated with generalized tonic-clonic seizures （GTCS） and 2 cases （5.1%） with absence seizures. GTCS and tonic seizures were five cases （12.8%） and 2 cases （5.1%）, respectively. Simple partial seizures were 3 cases （7.7%）. There were 24 ganglioglioma （61.5%）, 5 astrocytoma （12.8%）, 3 oligodendroglioma （7.7%）, 3 dysembryoplastic neuroepithelial tumor （DNET）（7.7%） and 4 the other types （10.3%） in the group. The tumors were located in the mesial and lateral temporal lobe were 71.8% and 28.2%, respectively. Mesial temporal lobe tumors involving hippocampus （71.4%） was significantly higher than that of the lateral group （9.1%）. MRI displayed the tumors as solid-cystic component, mainly solid and mainly cystic lesions were 46.2%, 30.8% and 23.1%, respectively. MRI Enhanced scan shows 25 caes （64.1%） with no enhancement. Inaddition to DNET located within the cortex with multiple small cystic characteristics, there were no significant difference on MRI manifestation of other tumor types. Conclusion： Temporal lobe tumoral epilepsy was common in children, which was mostly slow-growing tumor involving mesial or lateral cortex of the temporal lobe. Ganglioglioma is most common epiIeptogenic tumor in our patient group, DNET and low-grade gliomasin also appeared in the temporal lobe epilepsy group. The most common seizure

关 键 词：癫痫 颞叶 神经系统肿瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.1[医药卫生—诊断学]