多发胶质瘤的影像诊断

张 敬; 何雅娜; 李 威; 张云亭

中国临床医学影像杂志 ›› 2009, Vol. 20 ›› Issue (9) : 661-664.

论著

多发胶质瘤的影像诊断

张敬，何雅娜，李威，张云亭

作者信息 +

Imaging diagnosis of multiple glioma

ZHANG Jing, HE Ya-na, LI Wei, ZHANG Yun-ting

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文章历史 +

摘要

目的：阐述多发胶质瘤的病理类型组合特点及影像诊断要点。资料与方法：回顾分析8例经手术病理证实的多发胶质瘤的CT和MRI表现，其中男4例，女4例，年龄26～62岁，平均（47.0±13.0）岁。结果：8例患者每例发现2个胶质瘤，共16个胶质瘤。其中5例为多中心胶质瘤，3例为多灶性胶质瘤。5例多中心胶质瘤中3例两个肿瘤的病理类型不同，其中2例为混合性胶质瘤或少突胶质细胞瘤（Ⅱ级）合并星形细胞瘤（Ⅱ级），1例为DNET伴少突胶质细胞瘤成分（Ⅱ级）合并DNET（Ⅰ级），另2例两个肿瘤的病理类型相同，均为间变性星形细胞瘤（Ⅲ级）。3例多灶性胶质瘤两个肿瘤的病理类型均相同，1例为间变性星形细胞瘤（Ⅲ级），2例为多形性胶质母细胞瘤（Ⅳ级）。结论：多中心胶质瘤中肿瘤的病理类型可以相同，也可以不同，不同时根据肿瘤各自的影像表现可做出诊断，相同时则需要与转移瘤和淋巴瘤鉴别。

Abstract

Objective: To elucidate imaging diagnosis of multiple gliomas and correlate to pathology. Materials and Methods: Retrospectively analyze the CT and MRI imaging of 8 patients with multiple gliomas confirmed by surgery and pathology. Result: Sixteen gliomas were confirmed by pathology with 2 tumors in each patient. 5 patients were multicentric and 3 patients were mutifocal. 3/5 patients with multicentric had different histotypes. 2 patients were mixed glioma or oligodendroglioma(grade Ⅱ) accompanied with astrocytoma(grade Ⅱ). One patient was DNET with oliogodendrocytoma component accompanied with a pure DNET. 2/5 patients with multicentric had same histotype of anaplastic astrocytomas(grade Ⅲ). All 3 patients with multifocal glioma had same histotype. 1 was anaplastic astrocytomas(grade Ⅲ). 2 were glioblastoma multiform(grade Ⅳ). Conclusion: The histotype of multicentric gliomas may be same or different. When it is different, we can make the correct diagnosis by the imaging appearance of each glioma. When it is same, the differential diagnosis should include metastases and lymphoma.