侧脑室星形细胞瘤的MR成像与波谱分析  

Magnetic Resonance Imaging Spectroscopy of Astrocytoma in the Lateral Ventricles

作　　者：鱼潇 冒平[1] 李瑞春[1] 孙亲利[2] 鱼博浪[2] YU Xiao;MAO Ping;LI Ruichun;SUN Qinli;YU Bolang(Department of Neurosurgery,the First Affiliated Hospital of Medical College,Xi’an Jiaotong University,Xi’an 710061,China;不详)

机构地区：[1]西安交通大学第一附属医院神经外科,陕西西安710061 [2]西安交通大学第一附属医院医学影像科,陕西西安710061

出　　处：《中国医学影像学杂志》2019年第11期805-808,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨侧脑室星形细胞瘤的MRI表现特点、鉴别诊断及磁共振波谱(MRS)对其分级的价值。资料与方法回顾性分析经手术病理证实的18例侧脑室星形细胞瘤的MRI和MRS资料,所有患者均行MRI平扫、增强扫描和MRS检查,分析肿瘤信号、强化程度和波谱表现的诊断价值。结果Ⅱ级星形细胞瘤9例,Ⅲ级4例,Ⅳ级5例。肿瘤部位:右侧侧脑室三角区5例,左侧三角区4例,左侧室间孔区3例,右侧前角2例,左侧前角、右侧室间孔、左侧颞角和左侧体部各1例。肿瘤形态不规则,最大径20~35 mm,3例最大径大于50 mm,2例小于20 mm。肿瘤内均有不同程度的坏死,信号不均匀,不均匀显著强化。1例合并脑室内大量出血。高级别星形细胞肿瘤的MRS表现为胆碱波明显升高,胆碱与肌酸比值多明显大于4。结论侧脑室星形细胞瘤的MRI特点为容易坏死、囊变、信号不均匀、显著不均匀强化、与周围脑实质分界不清,综合分析可以提高诊断准确性,强化程度不能反映侧脑室星形细胞瘤的级别;MRS对侧脑室星形细胞肿瘤的分级有参考价值。Purpose To investigate the MRI features,differential diagnosis and the value of magnetic resonance spectroscopy(MRS)in lateral ventricle astrocytoma.Materials and Methods A retrospective analysis was carried out to analyze the MRI and MRS data in 18 lateral ventricular astrocytoma confirmed by post-surgicalpathology.MRI plain scan,contrast enhanced scan and MRS were performed to analyze the diagnostic value of tumor signal,degree of enhancement and spectral performance of these 18 cases.Results There were 9 cases of gradeⅡastrocytoma,4 cases of gradeⅢand 5 cases of gradeⅣ.Tumor site:5 cases located in the right lateral ventricle trigone,4 cases originated from the left lateral ventricle trigone,3 cases were near the left interventricular foramen,2 cases situated in the right anterior horn of lateral ventricle,1 case of tumor localized in each following area including left anterior horn of lateral ventricle,right interventricular foramen,left anterior horn of lateral ventricle and left lateral ventricle body.The tumors were irregular in shape,with a maximum diameter of 20-35 mm,3 cases with a maximum diameter greater than 50 mm,and 2 cases with a diameter less than 20 mm.There were different degrees of necrosis in the tumor,the signal was uneven,and the unevenness was significantly enhanced.One patient had massive hemorrhage in the ventricle.The MRS of high-grade astrocytic tumors showed a significant increase in choline waves,and the ratio of choline to creatine was significantly greater than 4.Conclusion The MRI features of lateral ventricular astrocytoma are necrosis,cystic degeneration,uneven signal,significant uneven enhancement,and unclear boundary with surrounding brain parenchyma.Comprehensive analysis can improve the diagnostic accuracy,and the degree of enhancement cannot reflect the grade of lateral ventricle astrocytoma.MRS has important value for the classification of lateral ventricular astrocytic tumors.

关 键 词：侧脑室 星形细胞瘤 磁共振成像 磁共振波谱学 诊断 鉴别 

分 类 号：R739.41[医药卫生—肿瘤] R730.42[医药卫生—临床医学]