目的 探讨儿童多形性黄色瘤型星形细胞瘤(pleomorphic xanthoastrocytoma,PXA)的CT及MRI表现,分析并总结其影像学特征。
方法 回顾性分析2009-07至2018-12医院经病理证实的儿童PXA的临床及影像资料,经入选及排除标准筛选,共12例患者入组,术前及术后均行CT、MRI检查。
结果 12例中6例病变位于颞叶,首发症状为癫
发作7例;影像上肿瘤完全实性1例,实性为主4例,囊实性混杂3例,囊内伴附壁结节4例,增强后肿瘤实性部分均有强化,囊内伴附壁结节类型肿瘤囊壁亦强化,瘤周水肿9例,钙化5例;术后病变全切除10例,病理证实为WHO Ⅱ级肿瘤6例。
结论 儿童PXA多位于大脑半球表浅位置,颞叶居多,癫
发作最常见;多伴有不同程度的囊性改变,肿瘤实性部分均有强化,囊壁亦可强化,水肿及钙化较常见,正确诊断尚需与儿童幕上常见肿瘤鉴别。
Abstract
Objective To explore the CT and MRI manifestations of pediatric pleomorphic xanthoastrocytomas, and to analyze the radiological features.Methods The clinical and radiological data of pediatric pleomorphic xanthoastrocytomas diagnosed histologically between July 2009 and December 2018 was analyzed retrospectively. After being reviewed by the inclusion and exclusion standards, a total of 12 patients were admitted. All the patients were given CT and MRI examination preoperatively and postoperatively.Results Among the 12 patients, half of the tumors were located in the temporal lobe. Seizure was the most common symptom, which occurred in 7 patients. Radiologically, the tumor was completely solid in one case, mainly solid in 4 cases, solid-cystic in 3 cases, and cystic with mural nodules in 4 cases. The solid parts of the tumors all had contrast enhancement. The cystic walls of the mural nodules were also enhanced. Edema and calcification could be seen in 9 and 5 patients, respectively. After operation, tumors were totally removed in 10 patients. Six patients were diagnosed as WHO Ⅱ pleomorphic xanthoastrocytomas.Conclusions Pediatric pleomorphic xanthoastrocytomas are mainly located in the cerebral hemisphere superficially, mostly in the temporal lobe. Seizures are the most common symptom. The tumors are usually associated with different degrees of cystic change. The solid parts of all the tumors and the cystic walls of mural nodules can be enhanced obviously. Peritumoral edema and calcification are not uncommon. Pleomorphic xanthoastrocytomas should also be distinguished from other supratentorial tumors.
关键词
星形细胞瘤 /
儿童 /
磁共振成像 /
诊断
Key words
astrocytoma /
child /
magnetic resonance imaging /
diagnosis
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参考文献
[1] Villa C, Miquel C, Mosses D, et al. The 2016 world health organization classification of tumours of the central nervous system [J]. Presse Med, 2018, 47(11-12 Pt 2): e187-e200.
[2] 李文华, 孙莲萍, 薛建平, 等. 儿童脑多形性黄色星形细胞瘤的MRI分析[J].放射学实践, 2004, 19(7): 491-493.
[3] Kepes J J, Rubinstein L J, Eng L F. Pleomorphic xanthoastrocytoma: a distinctive meningocerebral glioma of young subjects with relatively favorable prognosis. A study of 12 cases [J]. Cancer, 1979, 44(5): 1839-1852.
[4] Rao A A, Laack N N, Giannini C, et al. Pleomorphic xanthoastrocytoma in children and adolescents [J]. Pediatr Blood Cancer, 2010, 55(2): 290-294.
[5] 杨天昊, 崔世民, 靳 松, 等. 多形性黄色星形细胞瘤的CT及MR诊断[J]. 实用放射学杂志, 2009, 25(2): 160-162.
[6] 陈金卫, 梅 维, 张汉锡, 等. 多形性黄色星形细胞瘤的MRI表现与临床病理特征分析[J]. 现代中西医结合杂志, 2016, 25(6): 662-665.
[7] Byun J, Hong S H, Kim Y H, et al. Peritumoral edema affects the prognosis in adult pleomorphic xanthoastrocytoma: retrospective analysis of 25 patients [J]. World Neurosurg, 2018, 114: 457-467.
[8] Rutkowski M J,Oh T,Niflioglu G G, et al. Pleomorphic xanthoastrocytoma with anaplastic features: retrospective case series [J]. World Neurosurg, 2016, 95: 368-374.
[9] Gallo P, Cecchi P C, Locatelli F, et al. Pleomorphic xanthoastrocytoma: long-term results of surgical treatment and analysis of prognostic factors [J]. Br J Neurosurg, 2013, 27(6): 759-764.
[10] Lim S, Kim J H, Kim S A, et al. Prognostic factors and therapeutic outcomes in 22 patients with pleomorphic xanthoastrocytoma[J]. J Korean Neurosurg Soc, 2013, 53 (5): 281-287.
[11] Perkins SM, Mitra N, Fei W, et al. Patterns of care and outcomes of patients with pleomorphic xanthoastrocytoma: a SEER analysis [J]. J Neurooncol, 2012, 110(1): 99-104.
基金
国家“十二五”科技支撑计划(2014BAI04B01,2015BAI12B04)
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