| 陈绪珠,江涛,李少武,艾林,马军,戴建平.高级别胶质瘤动态变化的影像学观察(附15例分析)[J].中国医学影像技术,2007,23(10):1453~1456 |
| 高级别胶质瘤动态变化的影像学观察(附15例分析) |
| Radiological observation of dynamic change in high grade glioma: analysis of 15 cases |
| 投稿时间：2007-06-18 修订日期：2007-09-08 |
| DOI： |
| 中文关键词: 胶质瘤,高级别 自然病史 扩散 治疗 |
| 英文关键词:Glioma High-grade Natural history Diffusion Treatment |
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| 中文摘要: |
| 目的 分析15例高级别胶质瘤生长变化的影像学表现,初步总结其动态变化的影像学特征。方法 分析15例高级别胶质瘤(间变性星形细胞瘤和胶质母细胞瘤)的自然病史,通过对每一例患者自初次发病到最终手术的时间内所做的一系列影像学检查进行分析,仔细评价了首次检查时病灶位置、术前病灶累及的部位、动态影像学表现及生长趋势,所有病例均经病理证实。结果 全部15例病例中,男12例,女3例,初次发病时平均年龄为36.2岁(1~59岁)。自然病史周期平均31.2个月(范围2~106个月)。其中1例经活检证实,14例经手术切除并行病理检查。最终病理诊断包括4例间变性星形细胞瘤(WHO 3级),11例胶质母细胞瘤(WHO 4级),4例患者影像学阳性表现的出现滞后于临床表现,6例在生长过程中发生灶内出血,4例表现为自不强化到明显强化,3例在第一次影像学检查就表现出扩散征象,1例表现为多中心起病。结论 灶内出血、强化的动态变化可提示胶质瘤自低级别向高级别的恶变,高级别胶质瘤生长快、扩散早,一旦明确诊断,应立即进行治疗。 |
| 英文摘要: |
| Objective To summarize the dynamic radiological findings of high grade glioma by analyzing the serial radiological imaging of 15 cases of high grade glioma. Methods The natural history of 15 patients with high grade gliomas (anaplastic astrocytoma & glioblastoma) was identified. The tumour location on first examintion, the area involved by tumor on pre-operative imaging, kinetic radiological findings, and its growth tendency were carefully evaluated by serial radiological examinations in each patient. All of the cases were diagnosed by pathology after operation/biopsy. Results There were 3 women and 12 men with a mean age at first traceable imaging of 36.2 years (range, 1-59 years). Follow up imagings were available for an average period of 31.2 months (range, 2 to 106 months). Among the 15 cases, only 1 case was diagnosed by biopsy, the others were all underwent operation. Apart from 4 cases pathologically diagnosed as WHO grade Ⅲ (anaplastic astrocytoma), 11 cases were testified to be WHO grade Ⅳ(glioblastoma). The presence of positive radiological findings fell behind clinical symptoms in 4 cases. Hemorrhage was revealed in 6 cases. Four cases showed obvious change on post-contrast imaging with 3 cases exhibited diffusion at onset. Only 1 case showed multicentered lesions at first examination. Conclusion Intratumoral hemorrhage and dynamic change on post-contrast imaging may be signs of malignancy of low-grade glioma. High grade gliomas showed a highly infiltrating behavior. Once the diagnose was set up, immediate treatment is strongly recommended. |
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