摘要
目的分析上皮样胶质母细胞瘤(epithelioid glioblastoma,eGBM)患者的头颅磁共振成像(MRI)特征,并定量分析其表观弥散系数(ADC)、磁共振灌注加权成像(PWI)、磁共振波谱成像(MRS)特征。方法回顾性分析2016年10月至2018年11月青岛大学附属医院8例eGBM患者的MRI图像,观察病灶的部位、边缘、信号、瘤周水肿、邻近脑膜侵犯及强化特点,并分析其ADC、相对脑血流量(rCBF)、相对脑血容量(rCBV)、胆碱/N-乙酰天冬氨酸(NAA)的变化特点。结果 8例患者中肿瘤位于颞叶者3例,额叶3例,顶叶2例。6例病灶边界较清楚,2例边界不清。5例病变位置表浅,3例位于深部白质。3例病变内明显囊变,4例病变内可见坏死,1例无囊变坏死。1例病变周围无水肿,5例呈重度水肿,2例呈中度水肿。4例病变邻近脑膜受累,1例室管膜受累。2例术后2个月内出现软脑膜播散转移。8例eGBM患者肿瘤实质的平均ADC值为7.15×10^-4 mm^2/s,较对侧降低17.6%。MRS显示2例患者病变内胆碱/NAA分别为5.27、0.81。PWI显示2例患者病灶rCBV分别为3.51、3.32 ml/100 g,分别较对侧增高36%、29%;rCBF值分别为31.5、82.1 ml·100 g^-1·min^-1,分别较对侧增加49%、203%。结论 eGBM具有发病部位表浅,易囊变,但囊壁不光整且厚薄不均,肿块边界清楚,邻近脑膜易受累并出现脑膜尾征,容易发生脑脊液播散转移等特点。ADC值、PWI及MRS可为肿瘤的术前分级提供一定的定量依据。
Objective To analyze the magnetic resonance imaging(MRI)features of epithelioid glioblastoma(eGBM),and to quantitatively analyze the characteristics of apparent diffusion coefficient(ADC),perfusion-weighted imaging(PWI)and magnetic resonance spectrum(MRS)of eGBM patients.Methods The MRI results of eight cases of eGBM confirmed by pathology in the Affiliated Hospital of Qingdao University from October 2016 to November 2018 were analyzed retrospectively.The location,edge,signal,peritumoral edema,adjacent meningeal invasion and enhancement of the patients were observed,and the changes of ADC value,relative cerebral blood flow(rCBF),relative cerebral blood volume(rCBV)and the ratio of choline(Cho)/N-acetyl-L-aspartic acid(NAA)were analyzed.Results Among the eight patients,the main tumors were located in temporal lobe(n=3),frontal lobe(n=3)and parietal lobe(n=2).The boundary of the lesion was clear in six cases and unclear in two cases.The lesions were superficial in five cases and in deep white matter in three cases.Bleeding could be seen in four cases.There were three cases with cystic change and four cases with necrosis,and there was no cystic necrosis only in one case.There was no edema around the lesion in one case,severe edema in five cases and moderate edema in two cases.The adjacent meninge was involved in four cases and the ependyma was involved in one case.Two patients had leptomeningeal metastasis within two months after operation.The average ADC value of tumor parenchyma in eight patients was 7.15×10-4 mm^2/s,which was 17.6%lower than that of the contralateral side.MRS showed that the ratio of Cho/NAA in the lesions of two patients were 5.27,0.81.PWI showed that the rCBV in the lesions of two patients was 3.51 ml/100 g and 3.32 ml/100 g,respectively,which was 36%and 29%higher than that of the contralateral side,respectively.And the rCBF of the lesions was 31.5 ml·100 g^-1·min^-1and 82.1 ml·100 g^-1·min^-1,respectively,which increased by 49%and 203%respectively compared with the contralateral side.Conc
作者
赵继平
崔春晓
管帅
王家臣
刘芳
牛蕾
刘学军
Zhao Jiping;Cui Chunxiao;Guan Shuai;Wang Jiachen;Liu Fang;Niu Lei;Liu Xuejun(Department of Radiology,the Affiliated Hospital of Qingdao University,Qingdao 266555,China;Department of Radiology,the Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,China)
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2020年第7期513-519,共7页
Chinese Journal of Neurology
关键词
胶质母细胞瘤
磁共振成像
磁共振波谱学
诊断
鉴别
Glioblastoma
Magnetic resonance imaging
Magnetic resonance spectroscopy
Diagnosis
differential
