摘要
目的探索不同分级星形胶质细胞瘤的ＭＲＩ表现的规律性，研究ＭＲＩ对该肿瘤的诊断要点和诊断价值。方法搜集经ＭＲＩ诊断及手术病理证实的星形胶质细胞瘤（ＡＧ）２８０例，其中应用钆喷替酸葡甲胺（ＧｄＤＴＰＡ）增强成像８４例；取５０例肉眼全切标本，行ＭＲＩ表现的病理基础研究。结果发现Ⅰ级ＡＧ边界多较清楚，信号较均匀，水肿及占位效应较轻，囊变、出血少见，分别为３２％、１％；Ⅲ～Ⅳ级ＡＧ则边界多不清楚，信号不均，水肿及占位效应明显，囊变或坏死、出血多见，分别为５７％、２２％；Ⅱ级介于二者之间。众多ＭＲＩ征象中，有分级价值的特征为多位、多发、出血及坏死。而肿瘤在增强前后的信号不均匀性随着恶性度的增加呈递增趋势（Ｐ＜０．０１）。其病理基础主要与肿瘤内坏死、囊变、出血、含铁血黄素沉着等病理改变较多有关。另外，镜下尚发现瘤周水肿及邻近脑组织内有孤立肿瘤细胞浸润现象，而ＭＲＩ上无法分辨。结论不同分级的星形胶质细胞瘤的ＭＲＩ表现有一定规律性。
Objective To study specific features and main diagnostic points of astroglioma on MRI. Methods 280 cases of astroglioma were imaged with MRI and proved by pathology. 84 patients had Gd DTPA enhancement. The correlation of MRI and pathology were investigated in 50 cases of pathological specimens. Results The research showed that grade Ⅰ astroglioma was well defined with little mass effect and mild edema; The signal intensity was homogeneous. Cyst degeneration and hemorrhage were 32%、1%, respectively. Grade Ⅲ Ⅳ were poorly defined with marked mass effect and edema. The signal intensity was heterogeneous. Cystic degeneration or necrosis and hemorrhage were 57%, 22%, respectively. The MRI features of grade Ⅱ were between grade Ⅰ Ⅳ. The statistically significant MRI features were multi lesion necrosis or cystic degeneration and hemorrhage. The heterogeneity of signal increased with malignancy on MRI. The pathological bases were related to necrosis, cyst degeneation, hemorrhage, and hemosiderin deposition etc. Isolated tumor cell could be found at peritumoral edema and surrounding normal brain on pathological slices, which couldn't be identified on MRI. Conclusions There are regular MRI features of grade Ⅰ Ⅳ of astroglioma. The signal intensity of the tumor was related to pathological changes.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1999年第2期79-84,共6页
Chinese Journal of Radiology
基金
国家自然科学基金
