幕下神经节细胞胶质瘤多参数MRI特征  

Multi-parameter MRI features of infratentorial ganglioglioma

作　　者：凌浩 张亚林 陈丹[1] LING Hao;ZHANG Yalin;CHEN Dan(Department of Radiology,the Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha 410004,China)

机构地区：[1]南华大学附属长沙中心医院放射科,湖南长沙410004

出　　处：《实用放射学杂志》2022年第3期362-365,370,共5页Journal of Practical Radiology

摘　　要：目的探讨幕下神经节细胞胶质瘤(GG)的多参数MRI特征.方法回顾性分析经病理证实的11例患者幕下GG患者的多参数MRI表现,包括常规平扫和增强、扩散张量成像(DTI)、磁共振波谱(MRS)成像、动态磁敏感对比增强(DSC)成像.结果11例病灶均位于幕下,4例位于延髓-桥臂,1例位于延髓,2例位于桥脑,4例位于小脑半球.实性5例,囊实性6例,增强后9例病灶实性部分明显强化,2例轻度强化,脑干病灶呈半环形、结节、条片状强化,矢状位主要以延髓背侧强化为主.4例位于脑干的病灶伴有同侧小脑皮层萎缩.3例瘤周有轻度水肿.1例DTI示病灶周围神经纤维束局部破坏、中断,各向异性分数(FA)值为249.5±29.9.5例MRS示病灶实性部分N-乙酰天门冬氨酸与肌酸比值(NAA/Cr)降低,胆碱化合物与Cr比值(Cho/Cr)升高.2例DSC示病灶实性部分稍高灌注.结论幕下GG病灶强化方式表现多样,位于延髓病灶以背侧纵行分布为主,位于脑干病灶伴有同侧小脑皮层萎缩的特征,联合MR功能成像(DTI、MRS、DSC)的多参数成像方法,对诊断及鉴别诊断有帮助.Objective To explore the characteristics of multi-parameter MRI of infratentorial ganglioglioma(GG).Methods The multi-parameter MRI manifestations of 11 cases with infratentorial GG confirmed by pathology,including conventional plain scan and enhancement,diffusion tensor imaging(DTI),magnetic resonance spectroscopy(MRS)imaging and dynamic susceptibility contrast(DSC)were analyzed retrospectively.Results The lesions of 11 cases were all located in the subtentorial,4 cases were located in the medulla-pontine arm,1 case in the medulla oblongata,2 cases in the pons,and 4 cases in the cerebellar hemisphere.5 cases were solid and 6 cases were cystic-solid.After enhancement,the solid part of the lesions was significantly enhanced in 9 cases,and mildly enhanced in 2 cases.The brainstem lesions showed semicircular,nodular,and strip-like enhancement.The sagittal imaging was mainly dorsal enhancement of the medulla oblongata.4 cases of lesions located in the brain stem were accompanied by ipsilateral cerebellar cortical atrophy.3 cases had mild edema around the tumor.On DTI 1 patient showed local destruction and interruption of nerve fiber bundles around the leision,and fractional anisotropy(FA)value was 249.5±29.9.On MRS 5 patients showed a decrease in NAA/Cr and an increase in Cho/Cr in the solid part of the lesion.On DSC 2 patients showed slightly higher perfusion in the solid part of the lesion.Conclusion Infratentorial GG has various enhancement methods.The lesions located in the medulla oblongata are mainly distributed in the dorsal and longitudinal direction,and the lesions located in the brain stem are accompanied by the characteristics of ipsilateral cerebellar cortical atrophy.The multi-parameter imaging method combined with MR functional imaging(DTI,MRS,DSC)is helpful for diagnosis and differential diagnosis.

关 键 词：神经节细胞胶质瘤 幕下 磁共振成像 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]