脑胶质瘤的CT诊断、分型与病理对照研究(附70例报告)  

A Comparative Study Between Pathology and CT Classified Patterns and Diagnosis of the Golioma of the Brain (A Report of 70 Cases)

作　　者：蒲俊智[1] 志彦[1] 格根托娅[1] 关利君[1] 梅晓芳[1] 刘军[1] 

机构地区：[1]内蒙古呼和浩特市第一医院,内蒙古呼和浩特010020

出　　处：《实用放射学杂志》2002年第9期743-745,共3页Journal of Practical Radiology

摘　　要：目的　探讨脑胶质瘤的CT诊断、分型与病理之间的相关性。方法　搜集经CT诊断及手术病理证实的脑胶质瘤 70例 ,均行CT平扫及增强扫描和病理细胞学检查 ,将CT表现与病理结果进行对照分析。结果　 (1)本组CT诊断正确率为 85 .7%。 (2 )作者根据CT表现结合形态提出了脑胶质瘤的CT分型。Ⅰ型 (低密度无强化型 ) 16例 ,仅见于Ⅰ～Ⅱ级星形细胞瘤和少突胶质细胞瘤 ,后者常伴有弯曲条带状钙化或成簇点状钙化为其特征 ,本组占 3 3 % (3 9)。Ⅱ型 (环形强化型 ) 13例 ,多见于Ⅱ、Ⅲ、Ⅳ级星形细胞瘤 ,可见壁结节为其特征 ,占 5 3 .8% (7 13 )。主要病理改变为肿瘤内部坏死所致 ,少数为囊变。Ⅲ型 (结节及团块型 ) 3 1例 ,见于各种类型的脑胶质瘤 ,是髓母细胞瘤和室管膜瘤典型的CT表现。Ⅳ型 (混合型 ) 10例 ,为恶性胶质瘤的CT表现。 (3 )本组结果表明Ⅰ～Ⅱ级星形细胞瘤其水肿、占位效应以及强化程度以无或轻度为主 ,Ⅲ、Ⅳ级星形细胞瘤则以中或重度为主 ,两者均有显著差异。(4 )从肿瘤细胞学水平分析了脑胶质瘤的CT表现 ,为CT分型提供了病理学依据。结论　CT表现及分型可以反映脑胶质瘤的某些病理特征和间变情况 。Objective To study the relativity between pathology and CT diagnosis and CT classified types of the golioma of the brain.Methods Seventy cases of golioma confirmed by CT diagnosis and pathology by way of non-contrast CT scanning and enhanced scans were analysed in comparison the results of the pathology and CT appearances.Results (1)The accuracy rate of CT diagnosis was 85.7%;(2)having pointed out the CT classified types of the golioma of the brain a acording of CT appearances comibined with shape.Type Ⅰ was(low-tensity,non-enhancement types)16 cases,which can be only seen in Ⅰ and Ⅱ grade of astrocytoma oligodendroglioma,and the latter was often characterized by bending stripe-like calcification or cluster dot-like calcification,both of which occupy 33% of the total (3/9).Type Ⅱ was (ring-like enhanced patterns)13 cases,which often appeared in Ⅱ?Ⅲ?Ⅳ grade astrocytoma,charactenied by parietal-node which took up 53.8%(7/13).The pathology changes were mainly caused by the internal neceosis and a few by cystic changes.Type Ⅲ(nodular or mass-like enhancement) in 31 cases revealed by various types of goliomsas,which were typical CT appearances of medulloblastoma and ependymoma.Type Ⅳ(mixed types)in 10 cases had showed the CT appearances of malignant goliomas.(3)The results indicate that no or slight edema and mass effect as well as intensification were mainly seen in Ⅰ and Ⅱ grade astrocytomas,Ⅲ and Ⅳ grade astrocytomas were classified as the less serious and the serious both of which had distinctive differences.(4)Analyse the CT appearances of brain golioma in terms of tumor cytology had provided the pathology evidences for CT classified patterns.Conclusion CT appearances and CT classified patterns can reflect some pathologie characteristics and provide an important reference for astrocytoma pathology grading.

关 键 词：脑胶质瘤 X线计算机体层摄影 病理学 CT表现 临床分型 

分 类 号：R739.41[医药卫生—肿瘤]