螺旋CT对脑星形细胞瘤的诊断价值.docVIP

　　螺旋CT对脑星形细胞瘤的诊断价值 【摘要】 目的 分析脑星形细胞瘤的螺旋CT平扫、增强及增强时间-密度曲线表现，以提高对该病的诊断与分级诊断能力。方法 回顾性分析28例经手术病理证实的脑星形细胞瘤的CT平扫、增强及增强时间-密度曲线表现并与病理进行对照。结果 28例中，脑星形细胞瘤Ⅰ级5例，Ⅱ级8例，Ⅲ级8例，Ⅳ级7例。平扫Ⅰ～Ⅱ级呈低密度或等低混杂密度，位置较表浅;增强后Ⅰ级多无强化,水肿多轻或无;Ⅱ级呈断续或连续环结节形强化或片团状强化,水肿程度不一，增强时间-密度曲线Ⅰ～Ⅱ级与正常脑白质相似。Ⅲ～Ⅵ级多呈低等高混杂密度，位置较深在，水肿明显。多呈环结节型片团状伴囊变或厚壁花环状强化。Ⅲ～Ⅳ级增强时间-密度曲线与正常脑白质明显不同。结论 CT平扫、增强扫描及增强时间-密度曲线各种征象对脑星形胶质细胞瘤分级诊断，有重要价值。 【关键词】 脑星型细胞瘤;螺旋CT Abstract：Objective To analyze the performance of the brain astrocytoma through spiral CT scan, enhance scan and strengthen time- density curve to improve diagnosis and the ability in diagnostic classification.Methods By analyzing Retrospectively the performance of the CT scan, scan enhancement and strengthening time - density curve of 28 brain astrocytoma cases and paring it a grade Ⅰ, eight cases in gradeⅡ, eight cases in grade Ⅲ, seven cases in grade Ⅳ. Plain scanⅠ-Ⅱ level takes on a loixed density and the location is more superficial; Enhanced grade Ⅰ has not been strengthened, and the edema is lighter; Ⅱ level is intermittent or continuous ring-shaped nodules or strengthening of the film mission, edema varying e - density curve;Ⅰ - Ⅱ levels is similar to normal alba. Ⅲ - Ⅵ takes on a loixed density in the deeper positions and edema is more obvious, indicating Central-Mission-shaped nodules ent. Ⅲ ～ Ⅳ level of enhanced time - density curve is significantly different from the normal alba.Conclusions CT plain scan, enhanced scan and the various signs of the enhanced time - density curve play a significant role in the diagnosis classification of brain astrocytoma. 　　Key a; spiral CT 　　脑星形细胞瘤是脑内常见肿瘤，线为基线扫描，120 kV，250 mA，1s平扫，层厚5～10 mm，发现病变后先注入碘海醇20 mL，取肿瘤实质部位为感兴趣区做增强时间-密度曲线。然后行增强扫描。刘伟东，等：螺旋CT对脑星形细胞瘤的诊断价值辽宁医学院学报 2008年8月，29(4) 　　2 结 果 　　2.1 发病部位 额叶16例，颞叶6例，枕叶3例，第四脑室1例，跨叶者2例。 　　2.2 CT表现 平扫低密度者6例，混杂密度22例，伴钙化3例，出血1例。28例呈不同强度强化。其中Ⅰ～Ⅱ级脑星形细胞瘤13例，8例轻度强化，1例无强化，4例成明显强化。轻或无强化占69.23%(9/13)明显强化者占30.77%(4/13);病灶出血、坏死者5例，占38.46%(5/13)，无坏死或出血8例，占61.54%(8/13);病灶周围明显水肿者4例，占30.77%(4/13)，无或轻度水肿9例，占69.23%(