【摘要】 目的 探讨成人型弥漫性低级别星形细胞瘤（DA）的特征性MRI表现。方法 回顾性分析临沂市人民医院2019年2月至2023年3月10例经手术病理证实的弥漫性低级别星形细胞瘤的MRI及临床资料。7例行MRI平扫、增强扫描及磁共振波谱（MRS）检查、脑灌注（PWI）检查；2例行MRI平扫、增强扫描及MRS检查；1例行MRI平扫、增强扫描。扫描序列包括T1WI、T2WI、T2 flair、DWI(B=1000)及CET1WI序列。结果 肿瘤发生于右侧颞叶4例，左侧2例；右侧额叶1例，左侧1例；左侧顶叶区及右侧基底节区各1例。病变均为边界不清的弥漫性病灶，病变最大径16～41 mm，平均32 mm。与脑实质相比，MRI T1WI呈较均匀低信号9例，等信号1例；T2WI及T2 flair均呈较均匀高信号，DWI序列均未弥散受限；增强后病变均未强化。9例MRS均NAA峰明显下降，Cho峰明显升高。7例PWI均呈等低灌注。结论 弥漫性病灶，T1WI呈低信号，T2WI呈高信号，增强扫描不强化，MRS表现NAA峰下降、Cho峰升高为中青年弥漫性低级别星形细胞瘤的典型MRI征象。更多还原

【Abstract】 Objective To explore the characteristic MRI manifestations of adult-type diffuse low-grade astrocytoma(DA). Methods The MRI and clinical data of 10 cases with diffuse low-grade astrocytoma confirmed by surgical pathology in Linyi People’s Hospital from February 2019 to March 2023 were retrospectively analyzed. 7 cases underwent MRI plain scan, enhanced scan, spectral(MRS) examination, and cerebral perfusion(PWI) examination; 2 cases underwent MRI plain scan, enhanced scan, and MRS examination; 1 case underwent routine MRI plain scan and enhanced scan. The scanning sequences include T1WI, T2WI, T2 flair, DWI(B=1000), and CE-T1WI sequences. Results Tumors occurred in the right temporal lobe in 4 cases and in the left lobe in 2 cases; 1 case in the right frontal lobe and 1 case in the left lobe; 1 case in the left parietal lobe region and 1 case in the right basal ganglia region. The lesions were all diffuse lesions with unclear boundaries, with a maximum diameter of 16-41 mm and an average of 32 mm. Compared with the brain parenchyma, MRI T1WI showed a relatively uniform low signal in 9 cases and an equal signal in 1 case; Both T2WI and T2flair showed relatively uniform high signal intensity, and the DWI sequence did not have diffusion limitation; The lesions did not strengthen after enhancement. The NAA peak significantly decreased and the Cho peak significantly increased in MRS of all 9 cases. PWI result of 7 cases showed iso-hypoperfusion. Conclusion Diffuse lesions, low signal on T1WI, high signal on T2WI, no enhancement on enhanced scans, and decreased NAA peak and increased Cho peak in MRS are typical MRI signs of diffuse low-grade astrocytoma in young and middle-aged adults.更多还原