【摘要】 目的研究脑胶质细胞增生的CT、MRI及功能磁共振成像,并分析特点以提高诊断。方法回顾性分析2001年1月至2011年11月经开颅手术和病理检查证实的脑胶质细胞增生患者14例的CT、MRI平扫增强和功能磁共振成像表现,扫描设备为东芝16排螺旋CT和GESigna1.5TMR扫描仪,CT平扫7例,平扫后增强5例,MRI平扫12例,增强8例,功能成像弥散加权成像(DWI)检查3例,灌注加权成像(PWI)检查1例,磁共振氢质子波谱(1H-MRS)检查3例。结果发生部位颞叶5例(海马头部2例),顶叶3例,额叶2例,小脑蚓部2例,小脑蚓部及左小脑半球1例,1例广泛累及右额颞叶、基底节区及丘脑。组织学表现为神经元细胞变性,胶质细胞增生。CT平扫呈囊性低密度或不规则斑片样稍低密度,可伴钙化,CT增强不强化或轻度线样强化,MRI平扫呈囊样长T1长T2并FLAIR低信号或不规则斑片样稍长T1稍长T2并FLAIR稍高信号,MRI增强不强化或轻度线样强化,DWI显示为稍高信号,PWI大部分区域无血流灌注或显著低灌注,1H-MRS可见胆碱(Cho)峰升高,N-乙酰门冬氨酸(NAA)峰下降。结论 CT、MRI常规影像对脑胶质细胞增生的误诊率较高,结合功能磁共振成像可提高诊断正确率,特别是PWI的运用对于诊断有较大帮助。更多还原

【Abstract】 Objective To study the CT,MRI and functional MRI features of brain glial cell hyperplasia(BGCH).Methods CT,MRI plain scan and enhancement,1H-MRS,MRI poly functional imaging findings of 14 patients undergoing craniotomy surgery and with pathologically documented BGCH from January 2001 to January 2011 were retrospe ctively analyzed.A Thoshiba 16 detector CT and GE Signa 1.5 T MR Scanner CT plain scan 7 cases,enhancement after plain scan 5 cases,MRI plain scan 12 cases,MRI enhancement 8 cases,diffusion weighted imaging(DWI) 3 cases,perfusion weigted imaging(PWI) 1 case and 1H-MRS 3 cases.Results Out of 14 patients,the lesions were identified to be located at temporal lobe(n = 5)(including hippocampus head 2 cases),perialtal lobe(n = 3),frontal lobe(n = 2),vermiform process of cerebellum(n = 2),vermiform process of cerebellum and left cerebellar hemisphere(n = 1).These lesions were manifested histologically as neurons degeneration and glial cell hyperplasia.CT plain scan showed that the foci was of cystic low density or irregular plaque slightly low density,accompanying calcification.They were of no enhancement or slightly line enhancement.MRI plain scan showed that the disease was cyst-like long-T1,long-T2 and slightly hyperintense in Fluid-attenuated inversion recovery pulse sequence(FLAIR).MRI enhancement showed enhancement or slightly line enhancement.DWI showed slightly hyperintense.PWI showed that the main area of foci of no asanguineous perfusion or significant hypoperfusion.1H-MRS indicated increased choline and a slightly decreased N-aminosuccinic acid level.Conclusion Misdiagnosis rate of CT and MRI routine image is higher,but we can associate 1H-MRS and MRI poly functional image to improve diagnosis,especially the use of PWI.更多还原