弥散性神经胶质瘤病的临床诊断与治疗

摘要

Objective　To enhance the correctness in the diagnosis of diffuse neurogliomatosis.　Methods　Patients with diffuse neurogliomatosis were analyzed in terms of manifestations, signs, and MI images. Craniotomy was performed in 2 patients and stereotaxic biopsy in 2. The diagnosis was verified pathologically.　Results　Increased intracraniopressure was noted in all patients. Two brain lobes were involved in 1 patient, and 3 in others. MRI showed low or equal signal areas in T1W1, and high ones in T2W1. Brain edema was note without necrosis, cyst, and bleeding. MRI occupying effect was not significant, corpus callosum enlarged, and no enhancement demonstrated.　Conclusions　Diffuse neurogliomatosis has specific features on MRI. Craniotomy or stereotaxic biopsy was the best choice for diagnosis. Chemotherapy and radiotherapy should be used.%目的提高临床诊断弥散性神经胶质瘤的水平。方法对4例神经胶质瘤病例的临床症状、体征、MRI进行分析，2例开颅手术，2例CT立体定向活检术，均经病理证实为弥散性神经胶质瘤病。结果 4例均有颅内压增高表现，除1例病灶累及大脑2个脑叶外，其余均累及大脑3个叶。病灶在T1W1均呈低或等信号，在T2W1上呈高信号。局部脑组织肿胀，无坏死囊变及出血，占位效应不明显，增强扫描无明显强化，3例胼胝体肥大增厚。结论 MRI有其特有表现。手术或立体定向活检术是确诊该病的最佳选择。确诊后化疗及放疗应作为常规治疗的手段。