幕下节细胞胶质瘤的MR诊断及鉴别诊断  

MR diagnosis and differential diagnosis of infratentorial ganglioglioma

作　　者：黄聪 张恒胜 江桂华[2] 赵邦 周兴顺 罗军德 HUANG Cong;ZHANG Heng-sheng;JIANG Gui-hua;ZHAO Bang;ZHOU Xing-shun;LUO Jun-de(Department of Radiology,the 926 Hospital of PLA,Kaiyuan Yunnan 661699,China;Department of Radiology,the Second People’s Hospital of Guangdong Province,Guangzhou 510000,China)

机构地区：[1]中国人民解放军联勤保障部队第九二六医院放射科,云南开远661699 [2]广东省第二人民医院放射科,广东广州510000

出　　处：《中国临床医学影像杂志》2020年第7期462-465,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:分析幕下节细胞胶质瘤(GG)的MR表现,提高认识、提高术前诊断率。方法:回顾性分析8例经手术病理为幕下GG的临床、病理及MR资料。结果:病灶均位于幕下脑实质,多累及桥臂及邻近脑干、小脑半球。病灶形态多不规则,边界不清。T1WI主要呈低或稍低信号,T2WI及T2 FLAIR呈稍高或高信号,DWI以等或稍低信号为主,间变性GG DWI可呈不均匀高信号,增强呈条状或条片状不均匀强化,瘤周均有不同程度水肿带,同侧小脑半球均伴有脑皮层萎缩。1例接受1 H-MRS检查,瘤体主要代谢物NAA峰降低、Cho峰升高、Cr峰轻度下降,Cho/Cr升高,Cho/NAA升高。结论:幕下GG的MR表现与幕上不同,有其特征性的表现,当发现伴有同侧小脑皮层萎缩时,要考虑到此病的可能。Objective: To analyze the MR findings of infratentorial ganglioglioma(GG) in order to improve the recognition and the diagnostic rate before operation. Methods: Retrospective analysis of the clinical, pathological and MR data of 8 cases of infratentorial GG after surgery and pathology. Results: All the lesions were located in the infratentorial brain parenchyma,involving the middle cerebellar peduncles, adjacent brain stem and cerebellar hemisphere. The shape of the focus was irregular and the boundary was unclear. T1WI mainly showed hypointensity or slightly hypointensity, T2WI and T2FLAIR showed slightly hyperintense or hyperintense, and DWI mainly showed isointense or slightly hypointensity, anaplastic GG DWI may show uneven hyperintense. The enhancement is non-uniform in the shape of a strip or strip. There were different degrees of edema zone around the tumor, and the ipsilateral cerebellar hemisphere was accompanied with cerebral cortex atrophy. The main metabolites of the tumor: NAA peak decreased, Cho peak increased, Cr peak decreased slightly, Cho/Cr increased and Cho/NAA increased. Conclusion: The MR manifestation of infratentorial GG is different from that of supratentorial and has its characteristic manifestations. When it is found that the ipsilateral cerebellar cortex is atrophied, the possibility of this disease should be considered.

关 键 词：神经胶质瘤 幕下肿瘤 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]