脑室外室管膜瘤的磁共振成像影像表现与病理特征的相关性研究
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摘要
目的:研究脑室外室管膜瘤的磁共振成像(MRI)影像表现与病理特征的相关性。方法:选取2016年2月-2018年2月我院收治的脑室外室管膜瘤患者40例为研究对象。对所有患者均进行颅脑MRI平扫以及增强扫描检查,分析所有患者的临床病理特征情况,对比不同病理分级、不同病灶直径以及不同病灶部位患者的MRI表现。结果:脑室外室管膜瘤患者中病理分级为Ⅰ-Ⅱ级人数占比为75.00%,高于Ⅲ级的25.00%;病灶直径<6 cm人数占比为40.00%,低于病灶直径≥6 cm的60.00%;病灶部位在幕上的人数占比为20.00%,低于在幕下的80.00%。其中21例肿瘤实质部分均呈现稍长T1和稍长T2信号,另有19例肿瘤实质部分均呈等长T1和等长T2信号;所有患者的肿瘤囊性部分均呈长T1和长T2信号。病理分级为Ⅰ-Ⅱ级患者病灶位于浅表的人数占比明显高于Ⅲ级(P<0.05),病灶直径<6 cm患者合并周围水肿的人数占比高于病灶直径≥6 cm患者(P<0.05),病灶部位为幕上患者的MRI表现和病灶部位为幕下患者对比差异无统计学意义(P>0.05)。结论:MRI应用于诊断脑室外室管膜瘤效果明显,可清晰显示脑室外室管膜瘤病灶,且患者的MRI影像表现受病理分级、病灶直径影响。
Objective: To study the correlation between magnetic resonance imaging(MRI) features and pathological features of extra ventricular ependymoma. Methods: A total of 40 patients with extra ventricular ependymoma, who were treated in Second Affiliated Hospital of Shenyang Medical College from February 2016 to February 2018, were chosen as research subjects.All the patients underwent MRI scan and enhanced scan. The clinicopathological features of all the patients were analyzed. MRI imaging features of the patients with different pathological grade, lesion diameters and lesions location were compared. Results: The proportion of pathological grades with gradeⅠ-Ⅱin the patients with extra ventricular ependymoma was 75%, which was higher than 25.00% of grade Ⅲ. The proportion of lesion diameter <6 cm was 40.00%, which was lower than 60.00% of lesion diameter ≥6 cm. The proportion of lesions location on the curtain was 20.00%, which was lower than 80.00% of lesions location under the curtain. Among them, there were 21 cases with slightly longer T1 and slightly longer T2 signals in the tumor parenchyma, in addition, there were 19 cases with equal length T1 signals and equal length T2 signals in the tumor parenchyma, and all the patients showed long T1 and long T2 signals in the cystic part of tumor. The proportion of superficial lesions in the patients with pathological grade with grade I-II was significantly higher than that of grade III(P<0.05). The proportion of the patients with peripheral edema with <6 cm in the lesion diameter was higher than that of the patients with ≥6 cm in diameter greater(P <0.05). There was no significant difference in the MRI imaging features between the patients with lesion location on the curtain and with lesion location under the curtain(P >0.05). Conclusion: The effect of MRI on ependymoma of the ventricle is obvious, and it can clearly display the lesion of ependymoma of the ventricle,and MRI imaging features of patients are affected by pathological grade and lesion diameter.
Objective: To study the correlation between magnetic resonance imaging(MRI) features and pathological features of extra ventricular ependymoma. Methods: A total of 40 patients with extra ventricular ependymoma, who were treated in Second Affiliated Hospital of Shenyang Medical College from February 2016 to February 2018, were chosen as research subjects.All the patients underwent MRI scan and enhanced scan. The clinicopathological features of all the patients were analyzed. MRI imaging features of the patients with different pathological grade, lesion diameters and lesions location were compared. Results: The proportion of pathological grades with gradeⅠ-Ⅱin the patients with extra ventricular ependymoma was 75%, which was higher than 25.00% of grade Ⅲ. The proportion of lesion diameter <6 cm was 40.00%, which was lower than 60.00% of lesion diameter ≥6 cm. The proportion of lesions location on the curtain was 20.00%, which was lower than 80.00% of lesions location under the curtain. Among them, there were 21 cases with slightly longer T1 and slightly longer T2 signals in the tumor parenchyma, in addition, there were 19 cases with equal length T1 signals and equal length T2 signals in the tumor parenchyma, and all the patients showed long T1 and long T2 signals in the cystic part of tumor. The proportion of superficial lesions in the patients with pathological grade with grade I-II was significantly higher than that of grade III(P<0.05). The proportion of the patients with peripheral edema with <6 cm in the lesion diameter was higher than that of the patients with ≥6 cm in diameter greater(P <0.05). There was no significant difference in the MRI imaging features between the patients with lesion location on the curtain and with lesion location under the curtain(P >0.05). Conclusion: The effect of MRI on ependymoma of the ventricle is obvious, and it can clearly display the lesion of ependymoma of the ventricle,and MRI imaging features of patients are affected by pathological grade and lesion diameter.
引文
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[15]吴珊,乔文礼,赵凌舟,等.99mTc标记BmK CT及其胶质瘤荷瘤裸鼠的SPECT成像研究[J].现代生物医学进展,2017,17(18):3401-3405
[16]Wu CC,Guo WY,Chung WY,et al.Tumor pseudoprogression and true progression following gamma knife radiosurgery for recurrent ependymoma[J].J Chin Med Assoc,2016,79(5):292-298
[17]张婉,刘辉,刘金道,等.幕上脑实质内室管膜瘤CT、MRI表现及鉴别诊断[J].陕西医学杂志,2016,45(10):1349-1350
[18]梁菊香,邓新源,罗志程,等.CT及MRI在幕上脑实质室管膜瘤中的诊断价值[J].医学影像学杂志,2016,26(7):1178-1181
[19]Sabin ND,Merchant TE,Li X,et al.Quantitative imaging analysis of posterior fossa ependymoma location in children[J].Childs Nerv Syst,2016,32(8):1441-1447
[20]Chandra P,Purandare N,Shah S,et al."Drop"Metastases from an Operated Case of Intracranial Anaplastic Ependymoma Identified on Fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography[J].Indian J Nucl Med,2017,32(1):68-70
[21]Berhili S,Aissa A,Kadiri S,et al.Extra-axial ependymoma of the cerebral convexity:A very rare intracranial adult tumor[J].Neuroradiol J,2017,30(3):281-285
[22]Manzano-Lopez Gonzalez D,Conesa Bertran G,Lafuente Baraza J.Unusual case of posterior fossa syndrome and bilateral hypertrophic olivary degeneration after surgical removal of a large fourth ventricle ependymoma in an adult[J].Acta Neurochir(Wien),2015,157(7):1271-1273
[23]孙雁,钱丽霞.脑实质室管膜瘤核磁共振成像征象分析[J].中西医结合心脑血管病杂志,2015,13(1):108-110
[24]Zarinabad N,Wilson M,Gill SK,et al.Multiclass imbalance learning:Improving classification of pediatric brain tumors from magnetic resonance spectroscopy[J].Magn Reson Med,2017,77(6):2114-2124
[25]王红霞,陈昊,杨聪颖,等.室管膜瘤伴脂肪瘤分化2例并临床病理分析[J].临床与实验病理学杂志,2016,32(7):810-812
[26]Sabin ND,Merchant TE,Li X,et al.Quantitative imaging analysis of posterior fossa ependymoma location in children[J].Childs Nerv Syst,2016,32(8):1441-1447
[27]Tovar-Spinoza Z,Choi H.Magnetic resonance-guided laser interstitial thermal therapy:report of a series of pediatric brain tumors[J].J Neurosurg Pediatr,2016,17(6):723-733
[28]周浩亮,沈远望,李新胜,等.脑实质内室管膜瘤的MRI表现与病理结果比较分析[J].实用癌症杂志,2017,32(2):249-251
[29]Candanedo-Gonzalez F,Ortiz-Arce CS,Rosales-Perez S,et al.Immunohistochemical features of giant cell ependymoma of the filum terminale with unusual clinical and radiological presentation[J].Diagn Pathol,2017,12(1):7
[30]Prat-Acín R,Evangelista R,Conde R,et al.Neuroendoscopic management of posterior third ventricle ependymoma with intraaqueductal and fourth ventricle extension:a case report and review of the literature[J].Childs Nerv Syst,2017,33(11):2057-2060
[2]Bougaci N,Litrico S,Burel-Vandenbos F,et al.Unusual cauda equina syndrome due to multifocal ependymoma infiltrated by lymphoma[J].J Spine Surg,2017,3(4):697-701
[3]Haresh KP,Gandhi AK,Mallick S,et al.Prognostic Factors and Survival Outcomes of Intracranial Ependymoma Treated with Multimodality Approach[J].Indian J Med Paediatr Oncol,2017,38(4):420-426
[4]Kobayashi K,Ando K,Kato F,et al.MRI Characteristics of Spinal Ependymoma in WHO Grade II:A Review of 59 Cases[J].Spine(Phila Pa 1976),2018,43(9):E525-E530
[5]Kim SI,Lee Y,Kim SK,et al.Aggressive Supratentorial Ependymoma,RELA Fusion-Positive with Extracranial Metastasis:ACase Report[J].J Pathol Transl Med,2017,51(6):588-593
[6]Lucchesi KM,Grant R,Kahle KT,et al.Primary spinal myxopapillary ependymoma in the pediatric population:a study from the Surveillance,Epidemiology,and End Results(SEER)database[J].JNeurooncol,2016,130(1):133-140
[7]Zakrzewska M,Fendler W,Zakrzewski K,et al.Altered MicroRNAExpression Is Associated with Tumor Grade,Molecular Background and Outcome in Childhood Infratentorial Ependymoma[J].PLoS One,2016,11(7):e0158464
[8]王姗,任翠萍,白洁,等.不同年龄组幕上脑实质室管膜瘤ADC值特点分析[J].临床放射学杂志,2016,35(9):1337-1340
[9]Jeon I,Jung WS,Suh SH,et al.MR imaging features that distinguish spinal cavernous angioma from hemorrhagic ependymoma and serial MRI changes in cavernous angioma[J].J Neurooncol,2016,130(1):229-236
[10]Leng X,Tan X,Zhang C,et al.Magnetic resonance imaging findings of extraventricular anaplastic ependymoma:A report of 11 cases[J].Oncol Lett,2016,12(3):2048-2054
[11]王翅鹏,熊飞.幕上脑室外室管膜瘤的影像学诊断[J].中国医师进修杂志,2013,36(5):44-46
[12]徐焱,姚振威,韩芳,等.幕上脑实质室管膜瘤影像表现及病理对照分析[J].放射学实践,2014,29(9):1031-1034
[13]Takeda N,Nishihara M,Harada T,et al.Supratentorial extraventricular WHO grade III(anaplastic)ependymoma 17 years after total removal of WHO grade II ependymoma of the fourth ventricle[J].Br J Neurosurg,2017,31(2):270-272
[14]Yener U,Güdük M,Ek i M,et al.Concomitant Double Tumors of Myxopapillary Ependymoma Presented at Cauda Equina-Filum Terminale in Adult Patient[J].Korean J Spine,2016,13(1):33-36
[15]吴珊,乔文礼,赵凌舟,等.99mTc标记BmK CT及其胶质瘤荷瘤裸鼠的SPECT成像研究[J].现代生物医学进展,2017,17(18):3401-3405
[16]Wu CC,Guo WY,Chung WY,et al.Tumor pseudoprogression and true progression following gamma knife radiosurgery for recurrent ependymoma[J].J Chin Med Assoc,2016,79(5):292-298
[17]张婉,刘辉,刘金道,等.幕上脑实质内室管膜瘤CT、MRI表现及鉴别诊断[J].陕西医学杂志,2016,45(10):1349-1350
[18]梁菊香,邓新源,罗志程,等.CT及MRI在幕上脑实质室管膜瘤中的诊断价值[J].医学影像学杂志,2016,26(7):1178-1181
[19]Sabin ND,Merchant TE,Li X,et al.Quantitative imaging analysis of posterior fossa ependymoma location in children[J].Childs Nerv Syst,2016,32(8):1441-1447
[20]Chandra P,Purandare N,Shah S,et al."Drop"Metastases from an Operated Case of Intracranial Anaplastic Ependymoma Identified on Fluoro-2-deoxyglucose Positron Emission Tomography/Computed Tomography[J].Indian J Nucl Med,2017,32(1):68-70
[21]Berhili S,Aissa A,Kadiri S,et al.Extra-axial ependymoma of the cerebral convexity:A very rare intracranial adult tumor[J].Neuroradiol J,2017,30(3):281-285
[22]Manzano-Lopez Gonzalez D,Conesa Bertran G,Lafuente Baraza J.Unusual case of posterior fossa syndrome and bilateral hypertrophic olivary degeneration after surgical removal of a large fourth ventricle ependymoma in an adult[J].Acta Neurochir(Wien),2015,157(7):1271-1273
[23]孙雁,钱丽霞.脑实质室管膜瘤核磁共振成像征象分析[J].中西医结合心脑血管病杂志,2015,13(1):108-110
[24]Zarinabad N,Wilson M,Gill SK,et al.Multiclass imbalance learning:Improving classification of pediatric brain tumors from magnetic resonance spectroscopy[J].Magn Reson Med,2017,77(6):2114-2124
[25]王红霞,陈昊,杨聪颖,等.室管膜瘤伴脂肪瘤分化2例并临床病理分析[J].临床与实验病理学杂志,2016,32(7):810-812
[26]Sabin ND,Merchant TE,Li X,et al.Quantitative imaging analysis of posterior fossa ependymoma location in children[J].Childs Nerv Syst,2016,32(8):1441-1447
[27]Tovar-Spinoza Z,Choi H.Magnetic resonance-guided laser interstitial thermal therapy:report of a series of pediatric brain tumors[J].J Neurosurg Pediatr,2016,17(6):723-733
[28]周浩亮,沈远望,李新胜,等.脑实质内室管膜瘤的MRI表现与病理结果比较分析[J].实用癌症杂志,2017,32(2):249-251
[29]Candanedo-Gonzalez F,Ortiz-Arce CS,Rosales-Perez S,et al.Immunohistochemical features of giant cell ependymoma of the filum terminale with unusual clinical and radiological presentation[J].Diagn Pathol,2017,12(1):7
[30]Prat-Acín R,Evangelista R,Conde R,et al.Neuroendoscopic management of posterior third ventricle ependymoma with intraaqueductal and fourth ventricle extension:a case report and review of the literature[J].Childs Nerv Syst,2017,33(11):2057-2060