摘要
目的 探讨成人H3K27M突变型弥漫性中线胶质瘤的多模态MRI表现,提高该病诊断准确率,并为该类型肿瘤提供成像参考。方法 回顾性分析2017年1月至2021年5月经临床病理证实的成人H3K27M突变型弥漫性中线胶质瘤12例的临床及影像学资料。结果 12例H3K27M突变型弥漫性中线胶质瘤(男性10例,女性2例),其中丘脑4例(右侧3例,左侧1例);脑干5例(脑桥2例、延髓3例);颈胸段脊髓2例;小脑蚓部1例。12例病灶均为单发,11例实性,1例囊性,脊髓肿瘤都是长段病变。在MRI上的信号相对均匀;4例伴轻度水肿;6例病灶伴坏死,1例病灶可见出血,6例存在脑积水;7例DWI病灶见不同程度扩散受限,7例病灶可见流空血管信号;12例均呈不同程度强化;9例行MRS示Cho峰不同程度升高,NAA峰不同程度降低,1例出现高大p峰;4例行扩散张量成像(DTI)示病灶区神经纤维束稀疏,其中部分纤维束破坏中断2例,神经纤维束受压移位2例。结论 成人H3K27M突变型弥漫性中线胶质瘤的多模态MRI表现多样,但仍具有相对特征性的表现,充分认识这些特征表现,有助于临床诊断。
Objective To investigate the multimodal MRI manifestations of adult H3K27M mutant diffuse midline glioma,improve the diagnosis accuracy of the disease,and provide imaging reference for this type of tumor. Methods The clinical and imaging data of 12 cases of adult H3K27M mutant diffuse midline glioma confirmed by clinicopathology from January 2017 to May 2021 were retrospectively analyzed.Results 12 cases of H3K27M mutant diffuse midline glioma(10 males and 2 females),including 4 cases of thalamus(3 cases on the right side and 1 case on the left side);5 cases of brainstem(2 cases of pons and 3 cases of medulla oblongata);2 cases of cervical thoracic spinal cord;1 case of cerebellar vermis.All 12 cases were single lesions,11 cases were solid,1 case was cystic,and spinal cord tumors were all long-segment lesions. The signal on MRI was relatively uniform;4 cases with mild edema;6 cases with lesions with necrosis,1 case with hemorrhage,6 cases with hydrocephalus;7 cases with DWI lesions showed varying degrees of diffusion restriction,7 cases with flow Empty blood vessel signal;12 cases showed enhancement,of which 10 cases showed uneven enhancement;9 cases of MRS showed that the Cho peak increased to different degrees,the NAA peak decreased to different degrees,and 1 case showed a tall Lip peak;4 cases performed diffusion tensor imaging(DTI) showed sparse nerve fiber bundles in the lesion area,2 cases were partially damaged and interrupted,and 2 cases nerve fiber bundles were compressed and displaced. Conclusion Adult H3K27M mutant diffuse midline glioma multimodal MRI manifestations are diverse,but still have relatively characteristic manifestations. A full understanding of these manifestations is helpful for clinical diagnosis.
作者
祝华强
王东烨
毛家骥
许林森
沈君
ZHU Hua-qiang;WANG Dong-ye;MAO Jia-ji;XU Lin-sen;SHEN jun(Department of Medical Imaging,University of Chinese Academy of Sciences Shenzhen Hospital(Guangming),Shenzhen 518106,Guangdong Province,China;Department of Radiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,Guangdong Province,China)
出处
《中国CT和MRI杂志》
2023年第2期7-10,共4页
Chinese Journal of CT and MRI
作者简介
第一作者/通讯作者:祝华强,男,副主任医师,主要研究方向:头颈部、骨肌系统影像诊断。E-mail:dgzhuhuaqiang@163.com。
