Lee D Y, Chung C K, Hwang Y S, Choe G, Chi J G, Kim H J, Cho B K
Department of Neurosurgery, Seoul National University College of Medicine, Korea.
J Neurooncol. 2000 Apr;47(2):167-74. doi: 10.1023/a:1006401305247.
In order to elucidate the radiological features of dysembryoplastic neuroepithelial tumor (DNT), and to clarify the optimal surgical strategy for this tumor, the authors retrospectively analyzed 20 cases of DNT treated at our institution. Magnetic resonance (MR) imaging (all cases), 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) (eight cases), ictal/interictal Tc99m-HMPAO single photon emission computed tomography (SPECT) (seven and five cases respectively) and proton magnetic resonance spectroscopy (1H MRS) (one case) were performed preoperatively. Invasive monitoring/intraoperative electrocorticography (ECoG) was performed in four cases in order to determine the epileptogenic zone. A well-demarcated lobulating tumor located in the cortical with/without subcortical area was the typical MR finding. 18F-FDG PET showed glucose hypometabolism in all cases. Ictal Tc99m-HMPAO SPECT showed hyperperfusion of the lesion in three cases and interictal Tc99m-HMPAO SPECT showed hypoperfusion of the lesion in one case. 1H MRS showed nonspecific findings. Gross total resection was performed in all cases. Histologically, associated cortical dysplasia was found in 11 cases. The mean duration of follow-up after surgery was 37.9 months, and the overall seizure free rate was 90%. Follow-up MR imaging was performed in 14 cases (mean duration of follow-up: 21.6 months) and showed no recurrence of tumor in any of these cases. Invasive monitoring/intraoperative ECoG and the presence of cortical dysplasia showed no significant relationship with seizure control rate (p = 1.25 and p = 1.62 respectively).
为了阐明胚胎发育不良性神经上皮肿瘤（DNT）的影像学特征，并明确该肿瘤的最佳手术策略，作者回顾性分析了在本机构接受治疗的20例DNT病例。术前进行了磁共振（MR）成像（所有病例）、18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）（8例）、发作期/发作间期锝99m-六甲基丙烯胺肟单光子发射计算机断层扫描（SPECT）（分别为7例和5例）以及质子磁共振波谱（1H MRS）（1例）检查。为了确定致痫区，对4例患者进行了侵入性监测/术中皮质脑电图（ECoG）检查。典型的MR表现为位于皮质伴/不伴皮质下区域的边界清晰的分叶状肿瘤。18F-FDG PET显示所有病例均有葡萄糖代谢减低。发作期锝99m-六甲基丙烯胺肟SPECT显示3例病变处血流灌注增加，发作间期锝99m-六甲基丙烯胺肟SPECT显示1例病变处血流灌注减低。1H MRS显示非特异性表现。所有病例均行肿瘤全切除。组织学检查发现11例伴有皮质发育异常。术后平均随访时间为37.9个月，总体无癫痫发作率为90%。14例患者进行了随访MR成像（平均随访时间：21.6个月），所有这些病例均未显示肿瘤复发。侵入性监测/术中ECoG以及皮质发育异常的存在与癫痫控制率无显著相关性（p值分别为1.25和1.62）。
