CAJ | 학술논문

目的：分析颅内粒细胞肉瘤( granulocytic sarcoma, GS) CT及MRI影像学表现特点,提高该病诊断率。方法回顾分析经临床证实的颅内GS 9例的影像学及其他临床资料。结果本组CT及MRI检查主要表现为脑实质浸润伴出血4例,颅内肿瘤伴骨质破坏3例,脑膜侵犯2例。2例影像学检查诊断为GS；7例误诊,误诊为高血压脑出血及转移瘤各2例,脑肿瘤、颅底软骨肉瘤及颅内低压综合征各1例。9例经骨髓穿刺细胞学检查确诊为急性淋巴细胞白血病4例,急性粒细胞白血病3例,慢性粒单细胞白血病2例；3例先确诊白血病,后诊断GS,6例因颅神经症状首发经脑脊液检查发现典型GS细胞确诊GS。经相应治疗疾病进展死亡1例,缓解8例。结论颅内GS CT与MRI检查具有特征性表现,主要表现为脑实质浸润伴出血、颅内肿瘤伴骨质破坏及脑膜侵犯伴梗阻性脑积水等征象, CT和MRI联合检查有助于GS确诊,且对预后评价有一定帮助。
목적：분석로내립세포육류( granulocytic sarcoma, GS) CT급MRI영상학표현특점,제고해병진단솔。방법회고분석경림상증실적로내GS 9례적영상학급기타림상자료。결과본조CT급MRI검사주요표현위뇌실질침윤반출혈4례,로내종류반골질파배3례,뇌막침범2례。2례영상학검사진단위GS；7례오진,오진위고혈압뇌출혈급전이류각2례,뇌종류、로저연골육류급로내저압종합정각1례。9례경골수천자세포학검사학진위급성림파세포백혈병4례,급성립세포백혈병3례,만성립단세포백혈병2례；3례선학진백혈병,후진단GS,6례인로신경증상수발경뇌척액검사발현전형GS세포학진GS。경상응치료질병진전사망1례,완해8례。결론로내GS CT여MRI검사구유특정성표현,주요표현위뇌실질침윤반출혈、로내종류반골질파배급뇌막침범반경조성뇌적수등정상, CT화MRI연합검사유조우GS학진,차대예후평개유일정방조。
Objective To improve the understanding of intracranial granulocytic sarcoma( GS) and reduce misdiagno-sis by evaluating the CT and MRI findings. Methods The CT and MRI findings and other clinical data of 9 patients with GS proved by clinical features or pathology were retrospectively analyzed. Results CT and MRI imaging showed parenchymal in-filtration with hemorrhage in 4 cases, intracranial tumors with bone destruction in 3 cases, and 2 cases were showed meningeal involvement. Among of 9 cases, only 2 cases were diagnosed as GS initially. However, 7 cases were misdiagnosed:hyperten-sive intracerebral hemorrhage in 2 cases, metastases in 2 cases;brain tumors, skull base chondrosarcoma and intracranial hy-potension syndrome in one each. Through bone marrow aspiration cytology, 4 cases were diagnosed as acute lymphoblastic leu-kemia, 3 cases were diagnosed as acute myeloid leukemia, and 2 cases were diagnosed with chronic myelomonocytic leukemia. 3 cases of them were diagnosed as leukemia at first and confirmed as GS finally. Because of initial neurological symptoms and typical GS cells by examination of cerebrospinal fluid, 6 cases were diagnosed as GS correctively. After appro-priate treatment, 8 cases were cured and 1 case died. Conclusion Intracranial GS may mainly perform as parenchymal infil-tration ( hematoma) , intracranial tumor formation associated with bone destruction and meningeal involvement with obstructive hydrocephalus. Combined CT and MRI may be helpful for diagnosis and can provide valuable assistance to early treatment and prognostic evaluation.