上皮样胶质母细胞瘤5例MRI表现分析并文献复习
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摘要
目的分析、总结上皮样胶质母细胞瘤(eG BM)的MRI表现,提高术前诊断正确率。方法回顾性分析5例经病理证实的eG BM的MRI图像,观察内容主要包括病灶部位、边缘、信号、瘤周水肿及强化特点。结果 1例病变多发,4例单发,病灶主体位于颞叶3例,顶叶1例,额叶1例;病变边界均清楚;1例瘤周重度水肿,4例瘤周轻中度水肿;1例病变呈"花环样"明显强化,壁厚且毛糙,3例病变实性部分及囊壁明显强化,壁薄且光滑,未见壁结节。结论 eG BM的MRI表现具有一定的特征性,结合发病部位表浅、肿瘤边界清楚及年轻人多见等特点,有助于提高术前诊断正确率。
Objective To analyze and summarize the MRI features of epithelioid glioblastomaa and improve the accuracy of preoperative diagnosis.Methods MRI data from five cases of epithelioid glioblastomaa were analyzed retrospectively.The main findings included location,margin,tumor signal,peritumoral edema and enhancement.Results One case had multiple lesions and the other four cases were single.The lesions were located in the temporal lobe in three cases,parietal lobe in one case and frontal lobe in one case.All of the lesions were superficial with clear margins.One case had severe edema and the other four cases had mild to moderate edema around the tumors.One case presented rosette-like enhancement with thick and irregular wall and three cases presented significant enhancement in the solid part and cystic walls.The walls were thin and smooth with no nodules.Conclusion Epithelioid glioblastomaa has certain characteristics on MRI.The combination of superficial location,clear margin and younger age of onset is a helpful feature to improve the accuracy of preoperative diagnosis.
Objective To analyze and summarize the MRI features of epithelioid glioblastomaa and improve the accuracy of preoperative diagnosis.Methods MRI data from five cases of epithelioid glioblastomaa were analyzed retrospectively.The main findings included location,margin,tumor signal,peritumoral edema and enhancement.Results One case had multiple lesions and the other four cases were single.The lesions were located in the temporal lobe in three cases,parietal lobe in one case and frontal lobe in one case.All of the lesions were superficial with clear margins.One case had severe edema and the other four cases had mild to moderate edema around the tumors.One case presented rosette-like enhancement with thick and irregular wall and three cases presented significant enhancement in the solid part and cystic walls.The walls were thin and smooth with no nodules.Conclusion Epithelioid glioblastomaa has certain characteristics on MRI.The combination of superficial location,clear margin and younger age of onset is a helpful feature to improve the accuracy of preoperative diagnosis.
引文
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2杨学军,江涛.解读《世界卫生组织中枢神经系统肿瘤分类(2016年)》[J].中国神经精神疾病杂志,2016,42:321-329.
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5李海南,刘敏婷,成丽娜,等.上皮样胶质母细胞瘤4例临床病理分析[J].中国神经精神疾病杂志,2017,43:458-463.
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9李娟,凌雪冰,赖名耀,等.WHO(2016)中枢神经系统肿瘤新增分类上皮样胶质母细胞瘤的临床病理特征[J].中南大学学报(医学版),2018,43:64-68.
10 Tanaka S,Nakada M,Nobusawa S,et al.Epithelioid glioblastoma arising from pleomorphic xanthoastrocytoma with the BRAF V600Emutation[J].Brain Tumor Pathology,2014,31:172-176.
11张玲艳,张培丽,张学凌,等.巨细胞型胶质母细胞瘤的MRI与病理结果对照:附9例报告[J].磁共振成像,2016,7:932-936.
12赵艳娥,卢光明,李南云,等.多形性黄色瘤型星形细胞瘤影像学表现与临床病理对照[J].临床放射学杂志,2008,27:726-730.
2杨学军,江涛.解读《世界卫生组织中枢神经系统肿瘤分类(2016年)》[J].中国神经精神疾病杂志,2016,42:321-329.
3 Gasco J,Salinas P,Franklin B,et al.Multifocal epithelioid glioblastoma mimicking cerebral metastasis:case report[J].Neurocirugia,2009,20:550-554.
4曾英,肖华亮,杨新,等.上皮样胶质母细胞瘤临床病理观察[J].诊断病理学杂志,2018,25:414-419.
5李海南,刘敏婷,成丽娜,等.上皮样胶质母细胞瘤4例临床病理分析[J].中国神经精神疾病杂志,2017,43:458-463.
6管帅,孟祥水.上皮样胶质母细胞瘤1例[J].实用放射学杂志.2017,33:1809-1810.
7 Huang QL,Cao X,Chai X,et al.The radiological imaging features of easily misdiagnosed epithelioid glioblastoma in seven patients[J].World Neurosurgery,2019,124:527-532.
8 Broniscer A,Tatevossian RG,Sabin ND,et al.Clinical,radiological,histological and molecular characteristics of paediatric epithelioid glioblastoma[J].Neuropathology and Applied Neurobiology,2014,40:327-336.
9李娟,凌雪冰,赖名耀,等.WHO(2016)中枢神经系统肿瘤新增分类上皮样胶质母细胞瘤的临床病理特征[J].中南大学学报(医学版),2018,43:64-68.
10 Tanaka S,Nakada M,Nobusawa S,et al.Epithelioid glioblastoma arising from pleomorphic xanthoastrocytoma with the BRAF V600Emutation[J].Brain Tumor Pathology,2014,31:172-176.
11张玲艳,张培丽,张学凌,等.巨细胞型胶质母细胞瘤的MRI与病理结果对照:附9例报告[J].磁共振成像,2016,7:932-936.
12赵艳娥,卢光明,李南云,等.多形性黄色瘤型星形细胞瘤影像学表现与临床病理对照[J].临床放射学杂志,2008,27:726-730.