Wurm G, Parsaei B, Silye R, Fellner F A
Department of Neurosurgery, Landesnervenklinik Linz, Linz, Austria.
Acta Neurochir (Wien). 2004 Jan;146(1):19-26; discussion 26. doi: 10.1007/s00701-003-0151-x. Epub 2003 Dec 9.
Various supratentorial pathological conditions can mimic neoplastic cerebral lesions clinically as well as radiologically. Analysis of the neuroradiological findings, the clinical history, laboratory and other paraclinical data mostly help to narrow down the diagnosis of cerebral pathologies. Sometimes, however, histopathological analysis of the operative specimen after surgery reveals unexpected findings.
In a series of 197 operative procedures performed for glioma surgery between August 2000 and August 2002 we found six distinct cases mimicking supratentorial tumours. Clinicoradiological findings had suggested a neoplastic gliomatous process in all cases. But histopathological examination revealed that in reality one patient had been affected by a stroke, two by hypertensive encephalopathy, and one by radiation necrosis; multiple sclerosis was the underlying pathology in two patients.
Conditions which show features similar to those of neoplastic cerebral lesions require advanced magnetic resonance imaging (MRI). The benefit of such sophisticated imaging in relation to the costs is an important issue in this context. Further research in the field of modern image modalities is necessary to evaluate these noninvasive techniques for specification of intracerebral lesions.
多种幕上病理状况在临床及放射学上可模拟脑肿瘤性病变。对神经放射学检查结果、临床病史、实验室及其他辅助临床资料进行分析，大多有助于缩小脑病变的诊断范围。然而，有时手术后手术标本的组织病理学分析会揭示意外的结果。
在2000年8月至2002年8月期间进行的197例胶质瘤手术中，我们发现6例明显模拟幕上肿瘤的病例。所有病例的临床放射学检查结果均提示为肿瘤性胶质瘤病变。但组织病理学检查显示，实际上1例患者为中风，2例为高血压脑病，1例为放射性坏死；2例患者的基础病理为多发性硬化症。
表现出与脑肿瘤性病变相似特征的病症需要先进的磁共振成像（MRI）检查。在这种情况下，这种复杂成像的效益与成本之比是一个重要问题。现代成像方式领域的进一步研究对于评估这些用于明确脑内病变的非侵入性技术是必要的。
