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目的:分析不同级别脑星形细胞瘤的影像表现,探讨影像表现与脑星形细胞瘤病理分级的相关性。方法:收集经CT及MRI诊断和手术病理证实的脑星形细胞瘤85例,按病理诊断标准分为四级,Ⅰ级13例,Ⅱ级21例,Ⅲ级28例,Ⅳ级23例。对肿瘤大小、密度、水肿、钙化、强化程度、强化类型等CT表现与病理分级进行对照研究,采用卡方检验;对MRI表现的8个特征(信号不均匀性、囊变坏死、出血、越过中线、水肿、边界、强化程度及强化不均匀性)与星形细胞瘤病理分级进行统计分析,采用卡方检验。结果:(1)肿瘤的大小、钙化等情况在各组间差异无显著性(P>0.05);而肿瘤密度、瘤周水肿、强化程度及类型在各组间差异存在显著性(P<0.05)或高度显著性(P<0.01);(2)除越过中线外,其余7个MRI征象均对星形细胞瘤分级有较大的帮助,尤其是囊变坏死、边界、水肿、肿瘤强化程度及强化不均匀性在各级星形细胞瘤之间差异均有极显著性意义(P<0.01)。结论:星形细胞瘤影像表现与其病理分级有一定的相关性,CT及MRI对星形细胞瘤的分级诊断有较大的价值。
Objective: To analyze the imaging manifestations of different grades of astrocytoma and to explore the correlation between the imaging findings and pathological grade of astrocytomas. Methods: Totally 85 patients with brain astrocytoma confirmed by CT and MRI were divided into four grades according to the pathological diagnosis, including 13 cases of grade Ⅰ, 21 cases of grade Ⅱ, 28 cases of grade Ⅲ and 23 cases of grade Ⅳ. Tumor size, density, edema, calcification, enhancement, enhanced type CT performance and pathological grade control study, using chi-square test; MRI features of the eight features (signal uniformity, cystic degeneration, bleeding, Midline, edema, borderline, degree of enhancement and enhancement of inhomogeneity) and histopathological grade of astrocytomas were statistically analyzed using chi-square test. Results: (1) There was no significant difference in tumor size, calcification, etc between the groups (P> 0.05), while there were significant differences in tumor density, peritumoral edema, degree of enhancement and type in each group ) Or highly significant (P <0.01). (2) In addition to the midline, all the other seven MRI features are helpful in the classification of astrocytoma, especially cystic degeneration, border, edema, degree of tumor enhancement (P <0.01). There was a significant difference between astrocytomas and astrocytoma at different levels (P <0.01). CONCLUSION: The imaging findings of astrocytomas are related to their pathological grades. CT and MRI are of great value in the differential diagnosis of astrocytoma.