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目的 探讨脑胶质瘤的CT诊断、分型与病理之间的相关性。方法 搜集经CT诊断及手术病理证实的脑胶质瘤 70例 ,均行CT平扫及增强扫描和病理细胞学检查 ,将CT表现与病理结果进行对照分析。结果 (1)本组CT诊断正确率为 85 .7%。 (2 )作者根据CT表现结合形态提出了脑胶质瘤的CT分型。Ⅰ型 (低密度无强化型 ) 16例 ,仅见于Ⅰ～Ⅱ级星形细胞瘤和少突胶质细胞瘤 ,后者常伴有弯曲条带状钙化或成簇点状钙化为其特征 ,本组占 3 3 % (3 9)。Ⅱ型 (环形强化型 ) 13例 ,多见于Ⅱ、Ⅲ、Ⅳ级星形细胞瘤 ,可见壁结节为其特征 ,占 5 3 .8% (7 13 )。主要病理改变为肿瘤内部坏死所致 ,少数为囊变。Ⅲ型 (结节及团块型 ) 3 1例 ,见于各种类型的脑胶质瘤 ,是髓母细胞瘤和室管膜瘤典型的CT表现。Ⅳ型 (混合型 ) 10例 ,为恶性胶质瘤的CT表现。 (3 )本组结果表明Ⅰ～Ⅱ级星形细胞瘤其水肿、占位效应以及强化程度以无或轻度为主 ,Ⅲ、Ⅳ级星形细胞瘤则以中或重度为主 ,两者均有显著差异。(4 )从肿瘤细胞学水平分析了脑胶质瘤的CT表现 ,为CT分型提供了病理学依据。结论 CT表现及分型可以反映脑胶质瘤的某些病理特征和间变情况 ,对其分级有重要参考价值
Objective To investigate the correlation between CT diagnosis, typing and pathology in gliomas. Methods Seventy patients with gliomas confirmed by CT and pathology were enrolled in this study. Both CT scan and pathological cytology were performed on CT scan. CT findings and pathological findings were compared. Results (1) The correct rate of CT diagnosis in this group was 85.7%. (2) The authors put forward the CT classification of glioma according to the CT manifestations. Type I (low density without intensive type) in 16 cases, only seen in grade Ⅰ ~ Ⅱ astrocytoma and oligodendroglioma, which is often accompanied by curved banding calcification or clustered dot-like calcification as its characteristics, This group accounted for 33% (39). Ⅱ type (ring enhanced type) in 13 cases, more common in grade Ⅱ, Ⅲ, Ⅳ astrocytoma, visible wall nodules for its characteristics, accounting for 53.8% (7 13). The main pathological changes caused by necrosis of the tumor, a few cystic changes. Type Ⅲ (nodules and lumps) 31 cases, found in various types of gliomas, medulloblastoma and ependymoma typical CT manifestations. Ⅳ type (mixed type) in 10 cases, the CT manifestations of malignant glioma. (3) The results of this group show that grade Ⅰ ~ Ⅱ astrocytoma edema, mass effect and degree of enhancement to no or mild, grade Ⅲ, Ⅳ astrocytoma or moderate to severe, the two There are significant differences. (4) The CT findings of glioma were analyzed from the level of tumor cytology, which provided the pathological basis for CT typing. Conclusion CT findings and classification can reflect some of the pathological features of gliomas and changes in the situation, its classification has important reference value