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目的探讨肥胖细胞型星形细胞瘤(Gem A)的MRI特点及鉴别诊断。方法回顾性分析经病理证实的8例Gem A的临床资料和MRI表现,8例均行MRI平扫及增强扫描,其中1例加扫磁敏感加权成像(SWI)序列,分析其影像特征。结果 8例Gem A全部位于幕上,均为单发,其中累及额叶7例,颞叶1例;4例累及多个脑叶,并通过胼胝体侵犯对侧脑组织;6例边界不清,2例边界清晰;肿瘤囊变4例;1例表现为大囊结节型,实性结节位于肿瘤脑膜面。肿瘤的实性成分在T1WI呈等或稍低信号,在T2WI呈稍高或高信号,在扩散加权成像(DWI)上呈稍高或高信号,ADC图呈等或低信号;增强后肿瘤实性成分多呈明显不均匀强化。结论 Gem A的MRI表现有一定特异性,单发,好发于额叶,边界不清,可囊变,可累及胼胝体侵犯对侧额叶,增强扫描后肿块实性成分明显强化。
Objective To investigate the MRI features and differential diagnosis of obesity-cell astrocytoma (Gem A). Methods The clinical data and MRI findings of 8 cases of Gem A confirmed by pathology were analyzed retrospectively. All 8 cases underwent MRI plain scan and enhanced scan. Among them, one case was scanned with SWI sequence to analyze its imaging features. Results All 8 cases of Gem A were located on the screen, all of them were solitary ones, including 7 cases of frontal lobe and 1 case of temporal lobe. 4 cases involved multiple brain lobes and contralateral brain tissues were infiltrated by corpus callosum. 2 cases of clear boundary; cystic tumor in 4 cases; 1 case showed cystic nodules, solid nodules located in the tumor meningoencephalam. The real components of tumors showed equal or slightly lower signal intensity on T1WI, slightly higher or higher signal intensity on T2WI, slightly higher signal or higher signal on diffusion-weighted imaging (DWI) Sexual composition showed significantly uneven enhancement. Conclusion The MRI findings of Gem A have certain specificity. The single, the most frequent frontal lobe, the unclear boundary and the cystic degeneration may involve the corpus callosum invaginating the contralateral frontal lobe. The enhancement of the solid components in the enhanced scan is obvious.