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目的:探讨胶质母细胞瘤术后瘤周梗塞的MRI特征,并评价其临床意义方法:收集54例胶质母细胞瘤患者的临床、病理及影像学资料,全部患者于术后72小时内进行了MRI检查,并在6个月内进行MRI随访复查,回顾性分析术后临床及MRI表现。结果:术后72小时内MRI研究发现39例存在DWI局灶性弥散受限,病变位于肿瘤切除后空穴区附近。随访MRI研究发现90 %的弥散受限病灶已发展成为囊性脑软化,提示原来的局灶性弥散受限为脑梗塞表现,增强扫描44%的梗塞区有异常强化。9例手术后并发神经功能缺失,其中6例与MRI梗塞的分布区域密切相关。结论:恶性胶质瘤术后DWI弥散受限是一种脑梗塞表现,并具有一定临床意义,MRI随访观察中梗塞区异常强化容易误诊为肿瘤复发。
Objective: To investigate the MRI features of peri-tumor after glioblastoma surgery and to evaluate its clinical significance.Methods: The clinical, pathological and imaging data of 54 patients with glioblastoma were collected, all patients within 72 hours after operation The MRI examination was performed and MRI follow-up was performed within 6 months. Clinical and MRI findings were retrospectively analyzed. Results: MRI findings within 72 hours after surgery showed that there were 39 cases of DWI focal diffusion limited lesions located in the vicinity of the cavity after tumor resection. Follow-up MRI study found that 90% of diffusely restricted lesions have developed cystic brain softening, suggesting that the original focal diffusion limited to cerebral infarction, enhanced scan 44% of the infarct area abnormal enhancement. Nine cases had postoperative neurological deficits, of which six were closely related to the distribution of MRI infarcts. CONCLUSION: The limited diffusion of DWI in patients with malignant gliomas is a manifestation of cerebral infarction and has certain clinical significance. It is easy to be misdiagnosed as tumor recurrence due to the abnormal enhancement of infarct area in MRI follow-up observation.