CAJ | 학술논문

目的分析脑胶质瘤手术后播散的途径,阐述沿不同途径转移的MRI诊断依据.方法 10例经病理证实的脑胶质瘤手术后播散的患者均使用T_1WI、FSE T_2WI、FLAIR和增强后T_1WI脂肪抑制序列,其中4例进行DWI,1例SWI和DTI检查.手术后随访至少1次,最多5次.结果手术及病理证实的胶质母细胞瘤7例,星形细胞瘤Ⅲ级1例,星形细胞瘤Ⅱ级2例.手术后播散间隔最短者4月,最长者56月.所有病例均以增强后手术前及手术后对比阳性征象为标准,MRI平扫:T_1WI显示1/7例次线状增厚、呈等信号,5/7例次结节灶;T_2WI显示2/7例次脑沟、脑池变浅,5例次结节灶;FLAIR显示2/7例次脑池、脑沟变浅,6例次结节灶.结节状播散病灶与原发肿瘤主体部位信号接近一致7例,不一致3例.MRI增强扫描出现线状增厚7例次,出现结节7例次,类似"铸型状"征象6例次,脑积水6例次.结论 MRI增强扫描是诊断脑胶质瘤转移的可靠工具之一.
목적 분석뇌효질류수술후파산적도경,천술연불동도경전이적MRI진단의거.방법 10례경병리증실적뇌효질류수술후파산적환자균사용T_1WI、FSE T_2WI、FLAIR화증강후T_1WI지방억제서렬,기중4례진행DWI,1례SWI화DTI검사.수술후수방지소1차,최다5차.결과 수술급병리증실적효질모세포류7례,성형세포류Ⅲ급1례,성형세포류Ⅱ급2례.수술후파산간격최단자4월,최장자56월.소유병례균이증강후수술전급수술후대비양성정상위표준,MRI평소:T_1WI현시1/7례차선상증후、정등신호,5/7례차결절조;T_2WI현시2/7례차뇌구、뇌지변천,5례차결절조;FLAIR현시2/7례차뇌지、뇌구변천,6례차결절조.결절상파산병조여원발종류주체부위신호접근일치7례,불일치3례.MRI증강소묘출현선상증후7례차,출현결절7례차,유사"주형상"정상6례차,뇌적수6례차.결론 MRI증강소묘시진단뇌효질류전이적가고공구지일.
Objective To analyse the routes and MRI characteristics of disseminated intracranial gliomas after operation. Methods 10 patients of intracranial gliomas confirmed by pathology and intracranial dissemination after operation underwent MRI examina-tions including T_1 WI, FSE T_2 WI, FLAIR and fat-suppressed T_1 WI after intravenous injection of Gd-DTPA. In addition, 4 cases were also examinated with DWI, 1 case with SWI and DTI. Results In 10 cases,there were glioblastoma in 7 cases,grade Ⅱ astro-cytoma in 2 and grade Ⅲ astrocytoma in one. The disseminated tumors were found by MRI in 4 to 56 months after operation. The le-sions in all patients were confirmed with the comparison of contrast-enhanced MRI positive signs between preoperation and post-operation. Plain MR scanning showed line-like thicking with isointensity in 1/7 case/time (C/T)and multiple noduli in 5/7 (C/T) on T_1 WI respectively;shallowed cortical sulci and cistern in 2/7(C/T) and nodular in 5/7(C/T) on T_2 WI;shaUowed cortical aulci and cistern in 2/7 (C/T) and nodular in 6/7(C/T) on FLAIR. The signal intensity of noduli of disseminated tumors in 7 cases were in complete consistency with that of primary neoplasm , however, in 3 cases, it was inconsistent. Enhanced scanning showed 7 ca-ses with the signs of line-like thicking, 7 cases with noduli , 6 cases with :cast-like shape" sign and 6 cases with different extent of hydrocephalus. Conclusion Enhanced MRI can be used as a most useful and reliable monitoring tools for detecting dissemination of brain glioma.