小脑半球少突胶质细胞瘤的MRI表现  

Imaging features of oligodendroglioma in cerebellar hemispheres

作　　者：郑瑞平[1] 张勇[1] 程敬亮[1] 李颜良 卜春晓 

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052

出　　处：《实用放射学杂志》2018年第2期187-190,共4页Journal of Practical Radiology

摘　　要：目的 探讨小脑半球少突胶质细胞瘤（OD）的MRI征象，提高对OD的诊断水平。方法 回顾性分析7例经手术及病理证实的小脑半球OD的临床及术前MRI资料。结果 7例患者中，OD 4例，间变型少突胶质细胞瘤（AOD）3例。MRI平扫示T1WI呈低信号，T2WI呈明显高信号或混杂高信号；动态增强检查病灶时间-信号强度曲线（TIC）呈缓慢上升型；扩散加权成像（DWI）（b=1 000 s/mm2）检查病灶呈不均匀低信号或等低信号。OD和AOD的平均最小表观扩散系数（ADC）比率分别为1.753±0.784，1.660±0.551；磁共振波谱（MRS）表现为胆碱（Cho）峰明显升高，N-乙酰天门冬氨酸（NAA）峰明显降低，未见明显乳酸（Lac）峰。结论 小脑半球OD的MRI表现具有一定的特征性：病灶边界欠清，形态不规则，易囊变坏死，伴或不伴瘤周水肿，增强延迟强化，Cho峰升高，NAA峰降低及Lac峰缺失。Objective To improve the diagnosis of oligodendroglioma（OD） in cerebellar hemispheres and discuss MRI features. Methods Clinical and imaging data of 7 cases with OD in cerebellar hemispheres were analyzed retrospectively,which were confirmed by surgery and pathology.Results In 7 patients,4 patients were OD, and 3 patients were anaplastie oligodendroglioma{ AODJ.MRI showed hypointense on T1 WI and vividly hyperintense or mixed hyperintense on Tz WI.The time intensity curve（TIC）manifested rise slowly;DWI（b ~ 1 000 s/ram2 } showed homogeneously hypointense or iso-hypointense.The ratios of OD and AOD were 1.753 ~ 0. 784, 1.660 ~ 0.551 respectively; Magnetic resonance spectroscopy（ MRS） of oligodendrogliomas revealed a increased eholine（Cho） and reduced N-acetylaspartate（NAA） without lactate（Lae） peak.Conclusion MRI manifestation of OD in eerebellar hemispheres has certain characteristics：the boundary of lesion is unclear, irregular in shape,easy to cystic and necrotic, with or without peripheral edema of the tumor, delayed enhancement, higher in Cho peak,lower in NAA peak and lacking in Lae peak.

关 键 词：小脑半球 少突胶质细胞瘤 磁共振成像 

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