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目的 提高临床诊断弥散性神经胶质瘤的水平。 方法 对 4例神经胶质瘤病例的临床症状、体征、MRI进行分析 ,2例开颅手术 ,2例CT立体定向活检术 ,均经病理证实为弥散性神经胶质瘤病。 结果 4例均有颅内压增高表现 ,除 1例病灶累及大脑 2个脑叶外 ,其余均累及大脑 3个叶。病灶在T1W1均呈低或等信号 ,在T2 W1上呈高信号。局部脑组织肿胀 ,无坏死囊变及出血 ,占位效应不明显 ,增强扫描无明显强化 ,3例胼胝体肥大增厚。 结论 MRI有其特有表现。手术或立体定向活检术是确诊该病的最佳选择。确诊后化疗及放疗应作为常规治疗的手段。
Objective To improve the clinical diagnosis of diffuse glioma. Methods The clinical symptoms, signs and MRI of 4 cases of gliomas were analyzed, 2 cases of craniotomy and 2 cases of CT stereotactic biopsy were performed. All of them were proved to be diffuse gliomatosis by pathology. Results All 4 cases had increased intracranial pressure. Except for 1 case involving 2 cerebral lobes, the other 3 involved the brain. The lesions showed low or equal signal on T1W1 and high signal on T2W1. Local brain tissue swelling, cystic degeneration and no necrosis, placeholder effect was not obvious enhancement enhanced scan, 3 cases of hypertrophy of the corpus callosum. Conclusion MRI has its own unique features. Surgical or stereotactic biopsy is the best choice for diagnosis of the disease. After the diagnosis of chemotherapy and radiotherapy should be used as a routine treatment.