脑胶质肉瘤的MRI表现与病理对照分析  

MRI characteristics of gliosarcoma:Compared with pathology

作　　者：祁佩红[1] 郑红伟[2] 宋继安 薛鹏[1] 陈勇[1] 阎静[3] 

机构地区：[1]郑州人民医院医学影像科,河南郑州450012 [2]河南省胸科医院放射科,河南郑州450003 [3]郑州大学第一附属医院磁共振科,河南郑州450052

出　　处：《中国介入影像与治疗学》2016年第6期357-360,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨脑胶质肉瘤(GS)的MRI表现及相关病理学基础。方法回顾性分析22例经手术病理证实为GS的患者临床、MR及病理检查资料。结果 20例发生于大脑凸面,2例发生于深部脑白质;16例肿块呈圆形或类圆形,6例呈不规则形。22例肿瘤MRI均表现为不均匀团块状异常信号;20例为囊实性,2例为实性。4例为GS合并出血。肿瘤T2WI 21例呈以稍高信号或高信号为主的混杂信号,1例呈等信号;T1WI 18例呈不均匀稍低信号,4例呈不均匀低信号。21例可见瘤周水肿,1例瘤周无水肿。增强扫描表现为不均匀厚壁环状或花环状明显强化17例,壁结节强化7例,瘤内栅栏状强化14例。GS病理表现主要为胶质母细胞瘤成分与肉瘤成分呈间隔交替存在或肉瘤将胶质母细胞瘤分隔呈岛屿状。结论脑胶质肉瘤多位于大脑凸面,呈厚壁环形或花环状强化、壁结节及栅栏状强化是其特征性MRI表现,确诊仍需依靠病理学检查。Objective To investigate the MRI features and pathological foundations of gliosarcoma（GS）.Methed MRI features,pathological manifestations and clinical data of 22 patients with GS confirmed by pathology were retrospectively analyzed.Results GS lesions located in the brain convexity of 20 cases and in the deep white matter of 2cases.Totally 16 cases manifested as round or oval and 6cases as irregular shape lesions.MRI manifestations as inhomogeneous lump abnormal signal lesions were found in all of 22 cases.And 20 cases of them were cystic and 2cases were solid.Four cases combined with hemorrhage.For T2 WI,slightly high signals or mixed high signals were found in 21 cases and equal signal in another 1case.For T1 WI,inhomogeneous slightly low signals were found in 18 cases and inhomogeneous low signals in 4cases.There were 21 cases with peritumoral edema and the other 1case without edema.For enhanced MRI,there were 17 cases of uneven thick-walled annular ring or spend enhanced,7cases of nodular enhancement,14 cases of fence-like enhancement.The pathological manifestations of GS were glioblastoma cells alternate with sarcoma or sarcoma separate glioblastoma as islands.Conclusion GS lesions always occur in the brain surface.Uneven ring-like,thick wall or garland-like enhancement as well as wall nodule and palisade like appearances are classic MRI features.The final diagnosis still depends on pathological findings.

关 键 词：胶质肉瘤 磁共振成像 病理学 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]