大脑皮层弥漫性星形细胞瘤MRI分析

摘要

Objective:To investigate MRI appearance of cerebral cortical based diffuse astrocytoma(DA).Methods:Routine preoperative MR images of 21 cases of cerebral cortical based diffuse astrocytoma(pathologically proved NOS type) and relevant literatures were retrospectively analyzed.Results:Of the total 21 cases (23 lesions),most were located in the frontal lobe(16 cases).Most were cystic masses (about 65％) with T1 hypointensity and T2 hyperintensity.A minority were cystic and solid masses or swelling gyrus with subcortical patchy abnormal signals.Peritumoral edema was rare or mild with no contrast enhancement.One gemistocytic astrocytoma (about 6 cm in long diameter) showed a cystic and solid mass with moderate peritumoral edema and moderate patchy enhancement in the solid part.Two lesions were located in the frontal lobe with compression of thin cranial bone.Conclusion:High proportion of cystic mass is the main MRI feature of NOS type cerebral cortical based diffuse astrocytoma,which is helpful in diagnosis,differential diagnosis and prognosis evaluation.%目的:研究大脑皮层弥漫性星形细胞瘤(Diffuse astrocytoma,DA)的MRI表现.方法:收集21例主体位于大脑皮层并经病理证实的NOS型DA患者的术前常规MRI并结合相关文献进行回顾性分析.结果:共21例,23个病灶,额叶最多(16例).长T1长T2信号囊性肿块最多见(约65％),少数表现为囊实性肿块或脑回肿胀,可伴有皮层下斑片状异常信号;瘤周水肿多为无至轻度,增强后多不强化.1例肥胖细胞型星形细胞瘤(Gemistocytic astrocytoma,GemA)体积较大,长径约6 cm,表现为囊实性肿块,瘤周水肿中度,增强后实性部分片状中度强化;2个额叶病灶压迫颅板,表现为T1WI颅板局部变薄并信号减低;结论:大脑皮层NOS型DA囊性肿块比例较高,熟悉此特征将有利于诊断、鉴别诊断和对预后的判断.