CAJ | 학술논문

目的探讨脑胶质瘤病的影像学表现与临床及病理诊断,提高对该病的认识.方法回顾性分析26例脑胶质瘤病患者的影像学所见.结果手术部分切除8例,立体定向穿刺活检18例.影像学检查包括CT和MRI平扫及增强,12例行1H磁共振波谱分析(MRS)检查.所有患者病变都至少累及2个脑叶,其中22例CT和MRI表现为脑内大片状对称性低密度影和略长T1、长T2异常信号,增强扫描20例无明显强化,2例轻度强化,4例表现为大片状病灶不对称,增强扫描无强化.12例行1H MRS检查,表现为胆碱(CHO)/肌酸(Cr)、CHO/N-乙酰基天冬氨酸(NAA)升高,NAA/Cr不同程度降低,8例出现乳酸峰.结论 MRI是诊断脑胶质瘤病的首选检查方法；1H MRS 对该病的诊断及病理分级有重要帮助；MRI和活检相结合可明确诊断.
목적 탐토뇌효질류병적영상학표현여림상급병리진단,제고대해병적인식.방법 회고성분석26례뇌효질류병환자적영상학소견.결과 수술부분절제8례,입체정향천자활검18례.영상학검사포괄CT화MRI평소급증강,12례행1H자공진파보분석(MRS)검사.소유환자병변도지소루급2개뇌협,기중22례CT화MRI표현위뇌내대편상대칭성저밀도영화략장T1、장T2이상신호,증강소묘20례무명현강화,2례경도강화,4례표현위대편상병조불대칭,증강소묘무강화.12례행1H MRS검사,표현위담감(CHO)/기산(Cr)、CHO/N-을선기천동안산(NAA)승고,NAA/Cr불동정도강저,8례출현유산봉.결론 MRI시진단뇌효질류병적수선검사방법；1H MRS 대해병적진단급병리분급유중요방조；MRI화활검상결합가명학진단.
Objective To explore the imaging characteristics and the clinical and pathological diagnosis of gliomatosis cerebri in order to raise the awareness of the disease.Methods The images of 26 patients with gliomatosis cerebri were analyzed retrospectively.Results Eight patients were treated with partial excision and 18 patients got stereotactic biopsy.The radiography examination included the plain and enhanced scan of CT and MRI.Twelve patients received 1H magnetic resonance spectroscopy (MRS).The disease in all the patients involved at least two cerebral lobes.There were 22 cases whose CT and MRI manifestations showed that there were large-sheet symmetry low-density image in brain and slightly long T1 and long T2 abnormal signals.And the enhanced scan showed that 20 cases had no obvious enhancement,2 cases had slight enhancement.There were 4 cases with large-sheet asymmetry lesions and no enhancement in enhanced scan.1H MRS examination of 12 cases showed that choline( CHO )/creatine(Cr) and CHO/N-acetyl aspartic acid (NAA) increased,NAA/Cr decreased with different degree,and 8 patients had lactate peak.Conclusions MRI is the first choice to diagnose gliomatosis cerebri.1H MRS is very helpful for the diagnosis and pathological classification of the disease.MRI combined with biopsy can give out a definite diagnosis.