García-Santos José M, Torres del Río Silvia, Sánchez Ana, Martínez-Lage Juan F
Neuroradiology Section, Hospital General Universitario, J.Ma Morales Meseguer, C/Marqués de los Vélez s/n, 30008 Murcia, Spain.
Childs Nerv Syst. 2002 Aug;18(8):412-25. doi: 10.1007/s00381-002-0606-z. Epub 2002 Jun 26.
Among brain tumours, those arising from the deep brain are rare. In many cases they are low-grade astrocytomas. But primitive neuroectodermal tumours, ganglion cell tumours, oligodendrogliomas, lymphomas, and germinal neoplasms can also grow up from the basal ganglia and thalamic region. In other occasions peripheral neoplasms developing in neighbouring structures like the cerebral lobes, the ventricular walls, choroidal plexus, pineal gland and the hypothalamic-chiasmatic-suprasellar region can spread to the deep brain.
Imaging cannot reliably indicate that a histological picture for a tumour of this kind should be suspected. Although the macro- and microscopical characteristics of brain tumours are often the basis of the imaging findings, these data usually overlap and are only useful as an approximation tool.
Nonetheless, whilst radiologists and clinicians must always be cautious when evaluating the macroscopic peculiarities of a brain tumour, the value of imaging cannot be overestimated when any sort of pathology is encountered. Moreover, besides the classic CT and MRI findings, new MRI-related techniques, such as magnetic resonance spectroscopy (MRS), are able to extract a different kind of information from cerebral neoplasms, and they could be important widespread diagnostic alternatives in the very near future.
在脑肿瘤中,起源于深部脑区的肿瘤较为罕见。在许多情况下,它们是低级别星形细胞瘤。但原始神经外胚层肿瘤、神经节细胞瘤、少突胶质细胞瘤、淋巴瘤和生殖细胞瘤也可起源于基底节和丘脑区域。在其他情况下,发生在邻近结构(如脑叶、脑室壁、脉络丛、松果体以及下丘脑-视交叉-鞍上区)的周围肿瘤可蔓延至深部脑区。
影像学检查无法可靠地提示应怀疑此类肿瘤的组织学表现。尽管脑肿瘤的宏观和微观特征通常是影像学检查结果的基础,但这些数据通常存在重叠,仅作为一种近似工具使用。
尽管如此,放射科医生和临床医生在评估脑肿瘤的宏观特征时必须始终保持谨慎,但当遇到任何类型的病变时,影像学检查的价值不可高估。此外,除了经典的CT和MRI表现外,新的MRI相关技术,如磁共振波谱(MRS),能够从脑肿瘤中提取不同类型的信息,并且在不久的将来可能成为广泛应用的重要诊断手段。