González Toledo E, Nader M, Thomas-Ogunniyi J, Wilson J
Department of Radiology, Louisiana State University Health Sciences Center; Shreveport, LA, USA -
Neuroradiol J. 2012 Jul;25(3):325-9. doi: 10.1177/197140091202500307. Epub 2012 Jun 26.
Gangliogliomas are neoplasms with neuronal and glial components. The most common location is the temporal lobe and for that reason those patients have seizures as the major complaint. Gangliogliomas with anaplastic features are uncommon. A 33-year-old man presented with a two-year history of progressively worsening right-sided weakness and contractures. Physical examination demonstrated right-sided weakness and contractures involving the upper and lower extremities. Magnetic resonance demonstrated multiple nodules involving the tegmental pons with a small projection into the prepontine cistern on the left, midbrain tegmentum on the left in the subthalamic region. The patient was studied by MRI on T1WI, T2WI, FLAIR, DWI, and magnetic resonance spectroscopy. He underwent a craniotomy and biopsy of the mass. Histological examination of the specimen revealed glial proliferation. Based on these findings the pathologic diagnosis was anaplastic ganglioglioma. Only one previous report of an anaplastic astrocytoma in the cerebello-pontine angle in an adult has been published. In children three cases were reported, only one with magnetic resonance. Our case showed multiple nodular structures hypointense on T1 and hyperintense on T2 and FLAIR with enhancement on T1 after injection of paramagnetic contrast. Only in this contribution T2 value were diffusion-weighted and ADC characteristics and (1)H spectroscopy analyzed.
神经节胶质瘤是一种具有神经元和神经胶质成分的肿瘤。最常见的部位是颞叶，因此这些患者主要的症状是癫痫发作。具有间变特征的神经节胶质瘤并不常见。一名33岁男性，有两年进行性加重的右侧肢体无力和挛缩病史。体格检查显示右侧肢体无力和挛缩，累及上下肢。磁共振成像显示多个结节累及脑桥被盖部，左侧有一小突起延伸至脑桥前池，左侧中脑被盖部位于丘脑底区域。对该患者进行了T1加权成像（T1WI）、T2加权成像（T2WI）、液体衰减反转恢复序列（FLAIR）、扩散加权成像（DWI）和磁共振波谱检查。他接受了开颅手术并对肿块进行了活检。标本的组织学检查显示有胶质细胞增生。基于这些发现，病理诊断为间变性神经节胶质瘤。此前仅发表过一篇关于成人桥小脑角间变性星形细胞瘤的报告。在儿童中报告了3例，只有1例进行了磁共振成像检查。我们的病例显示多个结节状结构，在T1加权像上呈低信号，在T2加权像和FLAIR像上呈高信号，注射顺磁性造影剂后在T1加权像上有强化。仅在本研究中对T2值进行了扩散加权及表观扩散系数（ADC）特征分析和氢质子磁共振波谱（1H spectroscopy）分析。
