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目的探讨颅内神经元和混合性神经元-神经胶质肿瘤的磁共振波谱、灌注加权成像、扩散加权成像和磁敏感加权成像表现,提高术前诊断的准确性。方法回顾性分析6例经病理证实的神经元和混合性神经元神经胶质肿瘤的MRI表现,重点分析该类肿瘤MR生理代谢成像特征。结果神经节细胞胶质瘤及神经节细胞瘤各2例,乳头状胶质神经元肿瘤、胚胎发育不良性神经上皮肿瘤各1例。病变多为囊实性肿块,最大径平均为(3.98±1.26)cm,有不同程度强化,瘤周一般无或仅有轻度水肿。肿瘤多无明显扩散受限而表现为等低信号,实质区呈高灌注,其中1例为低灌注。胆碱有不同程度升高,氮-乙酰天门冬氨酸则多为降低表现,其中1例胆碱及氮-乙酰天门冬氨酸明显升高,磁敏感加权成像上肿瘤内有点片状低信号者2例。结论扩散加权成像、灌注加权成像及磁共振波谱等反映肿瘤生理代谢特征的MRI技术,对神经元和混合性神经元-神经胶质肿瘤的显示有一定特征性,结合常规MRI和临床表现能提高术前鉴别诊断能力。
Objective To investigate the expression of magnetic resonance spectroscopy, perfusion weighted imaging, diffusion weighted imaging and magnetic resonance weighted imaging in intracranial neurons and mixed neurons - glial tumors to improve the accuracy of preoperative diagnosis. Methods The MRI findings of 6 neuropathic and mixed neuronal gliomas confirmed by pathology were retrospectively analyzed. The features of MR metabolic imaging of these tumors were analyzed. Results There were 2 cases of glioma and gangliocytoma in ganglion, 1 case of papillary neuroglioma and 1 case of embryonic dysplastic neuroepithelial neoplasia respectively. Lesions were mostly cystic mass, the average diameter of the largest (3.98 ± 1.26) cm, with varying degrees of enhancement, general or no mild tumor edema. Tumor no obvious proliferation and showed low signal, the real area was high perfusion, of which 1 case of hypoperfusion. Choline increased to varying degrees, while N-acetyl-aspartic acid was mostly decreased. One case of choline and N-acetyl-aspartic acid was significantly increased, and a slightly flaky signal in the tumor on magnetically-sensitive weighted imaging 2 cases. Conclusion MRI, which reflects the features of tumor physiology and metabolism, such as diffusion-weighted imaging, perfusion-weighted imaging and magnetic resonance spectroscopy, has certain characteristic on the display of neurons and mixed neuron-glial tumors. Combined with conventional MRI and clinical manifestations, Preoperative differential diagnosis ability.