小脑幕上下H3K27M改变弥漫中线胶质瘤临床及影像分析  

Clinical and Imaging Features of Diffuse Midline Glioma in Supratentorial and Infratentorial Regions

作　　者：梁寿衡 马宇卉 王敏阳 崔光彬 LIANG Shou-heng;MA Yu-hui;WANG Min-yang;CUI Guang-bin(Department of Radiology,Tangdu Hospital,Air Force Medical University,Xi’an 710038,ShaanxiProvince,China)

机构地区：[1]空军军医大学唐都医院放射科,陕西西安710038

出　　处：《中国CT和MRI杂志》2023年第3期1-3,共3页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划(2019ZDLSF02-07)。

摘　　要：目的探讨小脑幕上下H3K27M改变弥漫中线胶质瘤(A-DMG)临床及磁共振(MRI)征象差异。方法回顾分析经病理证实的45例A-DMG的术前MRI和临床资料。临床资料包括年龄、性别、临床症状和KPS评分。MRI资料包括常规MRI特征和弥散加权成像(DWI)。结果年龄、肿瘤位置、T2-FLAIR错配征、囊变、出血、瘤周水肿、肿瘤边缘清晰度、室管膜侵犯、强化程度、强化占比、rADC、水肿最大径、.坏死最大径在幕上和幕下组中存在统计学差异(P<005)。性别、临床症状、KPS评分、有无坏死、坏死占比、强化模式、强化边缘清晰度在在幕上和幕下组中无统计学差异。肿瘤位于幕下时,内部信号均匀,缺乏囊变、坏死和出血,T2-FLAIR错配征多见;肿瘤边缘清晰,无瘤周水肿或范围较小;肿瘤强化程度较轻,呈点线状、环状或混合强化模式,强化区域范围小于肿瘤全部体积50%。结论幕上与幕下A-DMG的年龄及MRI征象存在差异,鉴别诊断时需要考虑肿瘤所在脑区位置。Objective To investigate the clinical data and magnetic resonance imaging(MRI)signs of diffuse midline glioma with H3 K27M alteration(A-DMG).Methods The preoperative MRI and clinical data of A-DMG confirmed by pathology were retrospectively analyzed.Clinical data included age,sex,clinical symptoms and KPS scores.The MRI features of the tumor were obtained by conventional MRI and diffusion weighted imaging(DWI).Results There were significant differences in age,tumor location,T2-FLAIR mismatch,cysts,hemorrhage,peritumoral edema,tumor edge,ependymal invasion,degree of enhancement,proportion of enhancement,rADC,maximum diameter of edema and necrosis between supratentorial and infratentorial groups(P<0.05).There were no significant difference in gender,clinical symptoms,KPS score,necrosis,proportion of necrosis,enhancing model and enhanced edge between the two groups.When the tumor is located under the tentorium,the internal signal is uniform,lacking cystic degeneration,necrosis and hemorrhage,and T2-FLAIR mismatch is more common;The tumor margin is clear,without peritumoral edema or small scope;The enhancement degree of the tumor is mild,showing a dot line,ring or mixed enhancement pattern,and the enhancement area is less than 50%of the total volume of the tumor.Conclusion There are differences in age and MRI signs between supratentorial and infratentorial of A-DMG.When differentiating tumors,it is necessary to consider the location.

关 键 词：H3 K27M改变 弥漫中线胶质瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]