【摘要】 目的　探讨颅内胶质瘤柔脑膜扩散的MR影像学特征 ,为临床治疗及估计预后提供参考。方法　共搜集颅内胶质瘤 945例 ,其中星形细胞瘤 6 2 0例、多形成胶质细胞瘤 32 5例 ,对其中具有柔脑膜扩散的 72例胶质瘤的临床及MRI资料进行回顾性分析。结果　 72例具有柔脑膜扩散的胶质瘤中 ,星形细胞瘤 2 9例 ,多形成胶质细胞瘤 43例 ,柔脑膜扩散发生率分别为 4 7%和 13 2 %。颅内胶质瘤柔脑膜扩散男、女发生率分别为 7 8%、7 3% ,经 χ2 检验 ,统计学上无显著性差异 (χ2 =0 831,P >0 .5 )。胶质瘤柔脑膜扩散可发生在任何年龄 ,星形细胞瘤柔脑膜扩散在各年龄组间的发生率无显著性差异 (χ2 =1 470 ,P >0 5 ) ,扩散病人的平均年龄 (36岁 )与未扩散病人的平均年龄 (35岁 )基本一致 ;多形成胶质细胞瘤柔脑膜扩散发生高峰在 6 0～ 6 7岁间 ,各年龄组间扩散发生率的差异具有显著性意义 (χ2 =2 1 75 ,P <0 0 0 5 ) ,高年龄组 (5 0岁以上 )患者较低年龄组 (5 0岁以下 )患者更易发生柔脑膜扩散 (χ2 =15 46 ,P <0 0 0 5 ) ,扩散病人平均年龄 (4 3岁 )比未扩散病人平均年龄 (38岁 )高。原发肿瘤大小对胶质瘤柔脑膜扩散影响不大 ,各组间差异无显著性意义 (χ2 星形细胞瘤 =1 6 32 ,P >0 2 5 ;χ2 成胶质细胞瘤 =0 5 4更多还原

【Abstract】 Objective To study the characteristics of leptomeningeal spread of intracranial gliomas on MR imaging, and to provide evidence for clinical treatment and evaluating prognosis. Methods The clinical and MR findings of 72 patients with leptomeningeal spread of gliomas were retrospectively analyzed, which were selected from 945 patients with intracranial gliomas verified by pathology. Results Of the 72 patients with leptomeningeal spread, 29 cases had astrocytoma, 43 cases had glioblastoma multiforme, the incidence of leptomeningeal spread was 4.7% and 13.2% respectively. There was no difference in the incidence of leptomeningeal spread of intracranial gliomas between the male(7.8%)and the female(7.3%)(χ 2=0.831, P >0.5), the leptomeningeal spread was seen more frequently in older age patients with high grade gliomas(χ 2=15.46, P <0 005), the size of primary tumor affected only slightly on leptomeningeal spread, leptomeningeal spread of gliomas had certain characteristic features. On MRI, there were five more typical signs of leptomeningeal spread: tail sign (30), line sign (17), strip sign (4), node sign (24), and diffuse leptomeningeal enhancement (7). Conclusion The leptomeningeal spread of intracranial gliomas can be readily visualized on MR imaging, thus providing the evidence for clinical treatment and predicting prognosis.更多还原