CAJ | 학술논문

目的：基于MRI分析探索初诊大脑半球胶质瘤瘤周水肿（peritumoral edema，PTE）特征对全切除术后复发部位趋向及复发形态的影响。方法收集来自4个临床中心43例经全切术后复发的胶质瘤病例的MRI资料，回顾性分析初诊时MRI的T2加权像所示PTE程度及类型对全切术后复发形态及部位趋向的影响。结果初诊胶质瘤PTE的特征对全切术后复发模式有显著影响，不仅复发形态在不同PTE程度间有明显差异（P=0.002），而且复发部位趋向在不同PTE程度间亦有明显差异（P=0.001），其中PTE程度轻者在复发形态上更倾向于局灶状(6/8)，复发部位趋向易趋于原位型(5/8)；PTE程度重者，复发形态易倾向于扩散状（30/35），复发部位趋向多为拓展型(25/35)、其次为周边型(7/35)。此外，全切术后复发形态在不同PTE类型间也存在明显差异（P<0.001），复发部位趋向在不同PTE类型间也存在明显差异（P<0.001），初诊时PTE为类圆型的复发形态以局灶状为多见(7/9)，复发部位趋向多数为原位型(6/9)，其次为周边型(2/9)和拓展型(1/9)；PTE呈不规则的复发部位趋向绝多数为拓展型(25/34)，其次为周边型(7/34)，少见原位型(2/34)。结论大脑半球胶质瘤PTE的程度、类型对肿瘤全切术后复发形态、部位趋向有显著的影响。
목적：기우MRI분석탐색초진대뇌반구효질류류주수종（peritumoral edema，PTE）특정대전절제술후복발부위추향급복발형태적영향。방법수집래자4개림상중심43례경전절술후복발적효질류병례적MRI자료，회고성분석초진시MRI적T2가권상소시PTE정도급류형대전절술후복발형태급부위추향적영향。결과초진효질류PTE적특정대전절술후복발모식유현저영향，불부복발형태재불동PTE정도간유명현차이（P=0.002），이차복발부위추향재불동PTE정도간역유명현차이（P=0.001），기중PTE정도경자재복발형태상경경향우국조상(6/8)，복발부위추향역추우원위형(5/8)；PTE정도중자，복발형태역경향우확산상（30/35），복발부위추향다위탁전형(25/35)、기차위주변형(7/35)。차외，전절술후복발형태재불동PTE류형간야존재명현차이（P<0.001），복발부위추향재불동PTE류형간야존재명현차이（P<0.001），초진시PTE위류원형적복발형태이국조상위다견(7/9)，복발부위추향다수위원위형(6/9)，기차위주변형(2/9)화탁전형(1/9)；PTE정불규칙적복발부위추향절다수위탁전형(25/34)，기차위주변형(7/34)，소견원위형(2/34)。결론대뇌반구효질류PTE적정도、류형대종류전절술후복발형태、부위추향유현저적영향。
Objective To explore the influence of peritumoral edema (PTE) on the tendency of recurrent location and morphological character after total resection using MRI. Methods MRI data was collected from 43 patients with recur-rent brain glioma after total resection from four clinical centers and then the influence of of PTE on recurrence patterns af-ter total resection was retrospectively analyzed based on the T2 weighted image. Results The PTE had a significant influ-ence on the recurrent patterns of brain gliomas after total resection. When PTE was mild, the shapes of recurrent gliomas tended to be focal (6/8) and the recurrent locations tended to be local (5/8). When PTE was severe, the shapes of the recur- rent gliomas tended to be spread(30/35 and the recurrent locations tended to be distant (25/35), followed by marginal (7/35), In addition, the morphological patterns and locations of recurrent gliomas were significantly different among different PTE types (all P<0.001). When PTE was ring shape, the shapes of recurrent gliomas tended to be focal (7/9) and the recur-rent locations tended to be local (6/9), followed by marginal (2/9) and distant (1/9). When PTE was irregular shape, most of recurrent locations tended to be distant (25/34), followed by marginal (7/34) but rarely local (2/34). Conclusions The de-grees and the types of brain glioma PTE can significantly influence the locations and morphological patterns of recurrent gliomas after total resection.