贵州医科大学学报

2005, (06) 516-519

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大脑胶质瘤病的核磁共振成像及核磁波谱成像
Diagnosis of Cerebri Gliomatosis with Magnetic Resonance Image and Magnetic Resonance Spectroscopy

陈广礼;焦俊;
CHEN Guang-li,JIAO Jun(Department of Radiology,The Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China)

摘要(Abstract):

目的:评价磁共振成像(MR I)、磁波谱成像(MRS)对大脑胶质瘤病诊断及病理分级的临床价值。方法:对11例经病理证实的大脑胶质瘤病MR I平扫、增强及病灶MRS综合影像学资料的回顾性分析。结果:所有病例均侵犯两个或两个以上脑叶,以颞叶、额叶、胼胝体常见,分别为91%、64%、64%。MR I表现:T1W I呈低或等低信号,T2W I呈高或混杂高信号,FLAIR像敏感,呈高信号,受累区脑组织轻度肿胀,邻近脑裂、脑沟变浅或消失,占位效应轻;注射Gd-DTPA增强扫描示,4例不规则、结节状强化,1例肿块样强化,2例线状轻度强化,4例无强化;DW I 3例弥散受限,8例弥散不受限。MRS:5例强化患者行MRS分析,肌酸(Cr)升高明显,胆碱复合物(Cho)中等程度的升高,N-乙酰天门冬氨酸(NAA)和乳酸、脂质(LL)降低,Cho/Cr、Cho/NAA比值升高,肿块样强化患者MRS数值变化明显。病理检查结果:肿瘤分级6例为星形细胞瘤I-II级,4例(强化)II-III级,1例(肿块样强化)IV级。结论:MR I,MRS对大脑胶质瘤病的诊断及病理分级有重要的临床价值。
Objective: To evaluate the clinical significance of diagnosis and pathologic grade of cerebri gliomatosis(CG) with magnetic resonance image(MRI) and magnetic resonance spectroscopy(MRS).Methods: MRI and MRS results of 11 cases of(CG) which have been confirmed by pathological examination were studied retrospectively.Results: The tumor involved at least 2 cerebral lobes in all the cases,especially temporal lobe(91%),frontal lobe(64%) and corpus callosum(64%).It demonstrated low or iso-low signal intensity on T1WI,hyperintensity on T2WI,and high sensitivity on FLAIR image,with slightly surrounding swelling,sulci disappearing and poor space occupying.After Gd-DTPA injection,nodular or irrigular enhancement occurred in 4 cases,mass enhancement in 1 case,poor thread enhancement in 2 cases,no contrast enhancement was found in the other 4 cases.In regard of DWI,the diffusion was limited in 3 cases,but not in the rest cases.It was showed in the results of enhanced MRS of 5 cases that Cho,Cr,Cho/Cr,and Cho/NAA levels were elevated,and NAA,LL levels were decreased.The pathological diagnosis of these cases were all astrocytoma.Among them,6 cases were grade I-II,4 cases(enhanced) grade II-III,and 1 case(mass enhancement) grade IV,Conclusion: MRI and MRS have significantly clinical value in the diagnosis of cerebri glimatosis and its pathologic grading.

关键词(KeyWords): 胶质母细胞瘤;磁共振成像;磁共振波谱学
glioblastoma;magnetic resonance imaging;magnetic resonance spectroscopy

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 陈广礼;焦俊;
CHEN Guang-li,JIAO Jun(Department of Radiology,The Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China)

DOI: 10.19367/j.cnki.1000-2707.2005.06.012

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