【摘要】 目的 评估T₂液体衰减反转恢复（FLAIR）影像中脑回浸润征对成人幕上无强化分子胶质母细胞瘤的诊断价值。方法 回顾性纳入13例无强化的分子胶质母细胞瘤以及38例弥漫性较低级别胶质瘤病人，分析2组病人的临床及影像学资料。所有病人术前均进行MRI常规及增强扫描。由2位影像科医师在不知晓病人的临床信息及病理结果的情况下，独立评估51例病人的MRI影像，重点观察T₂FLAIR影像上病变是否出现“脑回浸润征”。采用独立样本t检验及χ²检验对比分析2组临床特征及影像征象的差异，评估脑回浸润征对分子胶质母细胞瘤的诊断价值。结果 分子胶质母细胞瘤中的8例（8/13,62%）和弥漫性较低级别胶质瘤病人中的1例（1/38,3%）出现脑回浸润征，两者之间此征象出现率的差异具有统计学意义（χ²=21.13,P<0.01）。脑回浸润征诊断分子胶质母细胞瘤的敏感度为62%（95%CI:35.1%～82.3%）；特异度为97%（95%CI:86.2%～99.5%）。结论 脑回浸润征是分子胶质母细胞瘤的较特异性影像学征象，其有助于区分无强化的分子胶质母细胞瘤与弥漫性较低级别胶质瘤，从而提高其术前诊断准确率。更多还原

【Abstract】 Objective To evaluate the differential diagnostic value of the gyriform infiltration sign on T₂-FLAIR sequence for adult supratentorial non-enhancing molecular glioblastomas.Method sThirteen patients with non-enhancing molecular glioblastoma and 38 patients with diffuse lower-grade glioma were retrospectively included. Clinical and imaging data of the two groups were analyzed. All patients underwent preoperative conventional and contrast-enhanced MRI. Two radiologists, blinded to clinical information and pathological results, independently evaluated the MRI images of 51 patients,focusing on whether the gyriform infiltration sign was present on T₂-FLAIR images. Independent-sample t-test and chisquare test were used to compare differences in clinical characteristics and imaging features between the two groups, and to assess the diagnostic value of the gyriform infiltration sign for molecular glioblastomas.Results The gyriform infiltration sign was observed in 8 of 13 patients（62%） with molecular glioblastoma and 1 of 38 patients（3%） with diffuse lower-grade glioma. The difference in the incidence of this sign between the two groups was statistically significant（χ²=21.13, P<0.01）.The sensitivity of the gyriform infiltration sign for diagnosing molecular glioblastomas was 62%（95%CI: 35.1%-82.3%）, and the specificity was 97%（95%CI: 86.2%-99.5%）.Conclusion The gyriform infiltration sign is a relatively specific imaging feature of molecular glioblastoma. It can help differentiate non-enhancing molecular glioblastoma from diffuse lower-grade glioma and improve preoperative diagnostic accuracy.更多还原