摘要
目的分析脑干神经节神经胶质瘤(GG)的临床特征、手术策略以及预后情况。方法对2010年2月至2017年8月收治的46例脑干GG患者的临床资料进行回顾性分析,总结其临床及影像学特点、手术方法及预后。结果46例脑干GG患者年龄(22.5±4.6)岁,病程(38.1±8.9)个月,主要首发症状为头晕头痛占47.8%(22/46)。MRI结果显示,内生型5例,外生型10例,内生-外生型31例。将外生型作为非浸润脑干组(10例),将内生型和内生-外生型作为浸润脑干组(36例)。肿瘤轴位T1WI呈"新月征"20例(43.5%,20/46),矢状位T1WI呈特征性"斑片状"31例(67.4%,31/46)。行肿瘤全切除13例,次全切除9例,大部分切除16例,部分切除7例,仅活检1例,无一例手术相关性死亡。随访3~87(40.6±12.8)个月,5例死亡,均为浸润脑干组;非浸润脑干组无进展生存期明显长于浸润脑干组[(46.0±13.1)个月比(19.5±8.9)个月],差异有统计学意义(P<0.05)。结论大多数脑干GG有其特征性影像学表现,仍以手术切除为首选,外生型脑干GG应尽量行全切除,该类患者长期预后较好。
ObjectiveTo analyze the clinical and imaging features, surgical strategy and prognosis in patients with brainstem gangliogliomas (GG).MethodsThe clinical data of 46 patients with brainstem GG from February 2010 to August 2017 were retrospectively analyzed. The clinical and imaging features, surgical methods and prognosis were reviewed.ResultsThe age of 46 brainstem GG patients was (22.5 ± 4.6) years, the duration was (38.1 ± 8.9) months, and the most common symptoms were dizziness and headache, accounting for 47.8% (22/46). The MRI results showed that endogeny type was in 5 cases, exogenesis type in 10 cases, and endogeny- exogenesis type in 31 cases. The exogenesis type was enrolled as non-infiltrate brainstem group (10 cases), and the endogeny type and endogeny-exogenesis type were enrolled as infiltrate brainstem group (36 cases). The axial T1WI showed that the crescent sign was in 20 cases (43.5%, 20/46), and the sagittal T1WI showed that the patching sign was in 31 cases (67.4%, 31/46). Among all patients, total resection was achieved in 13 cases, near total resection in 9 cases, subtotal resection in 16 cases, partial resection in 7 cases and biopsy in 1 case. No operative death occurred. The patients were followed up for 3 to 87 (40.6 ± 12.8) months, and 5 patients died (all in infiltrate brainstem group). The progression-free survival in non-infiltrate brainstem group was significantly longer than that in infiltrate brainstem group: (46.0 ± 13.1) months vs. (19.5 ± 8.9) months, and there was statistical difference (P<0.05).ConclusionsMost brainstem GG has some unique MRI characteristics. Microsurgical resection might be preferred. Tumors that locate outside the brainstem can be fully removed. The long-term prognosis of brainstem GG is better.
作者
崔健
王钢
温大平
杭军
刘旭
Cui Jian;Wang Gang;Wen Daping;Hang Jun;Liu Xu(Department of Neurosurgery,the First Hospital of Xi'an City,Xi'an 710002,China)
出处
《中国医师进修杂志》
2019年第1期46-49,共4页
Chinese Journal of Postgraduates of Medicine
