Kikuchi Keiichi, Hiratsuka Yoshiyasu, Kohno Shohei, Ohue Shiro, Miki Hitoshi, Mochizuki Teruhito
Department of Radiology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
Department of Radiology, Ehime University School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
J Neuroradiol. 2016 Jul;43(4):260-5. doi: 10.1016/j.neurad.2015.10.006. Epub 2015 Dec 28.
Glioblastoma (GBM) is the most common type of malignant primary central nervous system tumor in adults; however, the prevalence of GBM arising in the cerebellum is extremely low. This study aimed to demonstrate the radiological features of cerebellar GBMs, including computed tomography (CT), magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and (18)F-fluorodeoxyglucose (FDG)- and (11)C methionine (MET)-positron emission tomography (PET) findings.
We retrospectively reviewed seven patients with cerebellar GBM (six men and one woman: mean age: 56 years, range: 18-73 years). We reviewed medical records and radiological data, including preoperative CT, MRI and PET. All patients underwent CT and MRI. DWI data were acquired in four patients. Three patients underwent FDG- and MET-PET examinations. All patients underwent total or subtotal tumor resection and received pathological diagnoses.
Four patients had imaging findings consistent with GBM and received preoperative cerebellar GBM diagnoses. Two patients exhibited homogeneous patchy and nodular enhancement without necrosis on MRI, which resembled malignant lymphoma and metastasis. One case exhibited Lhermitte-Duclos disease-like parallel linear striations (i.e.,"tiger-striped" appearance). Although the imaging findings of these three patients were inconsistent with GBM, pathological diagnosis confirmed cerebellar GMB.
Some evaluated cases of cerebellar GBM did not exhibit the common CT, MRI, and PET findings of supratentrial GBM, leading to considerable difficulty with preoperative differential diagnosis.
胶质母细胞瘤(GBM)是成人中最常见的原发性中枢神经系统恶性肿瘤类型;然而,发生于小脑的GBM患病率极低。本研究旨在阐述小脑GBM的放射学特征,包括计算机断层扫描(CT)、磁共振成像(MRI)、扩散加权成像(DWI)以及(18)F-氟脱氧葡萄糖(FDG)和(11)C-蛋氨酸(MET)正电子发射断层扫描(PET)表现。
我们回顾性分析了7例小脑GBM患者(6例男性,1例女性;平均年龄:56岁,范围:18 - 73岁)。我们查阅了病历及放射学数据,包括术前CT、MRI和PET。所有患者均接受了CT和MRI检查。4例患者获取了DWI数据。3例患者接受了FDG和MET - PET检查。所有患者均接受了肿瘤全切或次全切,并获得了病理诊断。
4例患者的影像学表现符合GBM,并获得了术前小脑GBM诊断。2例患者在MRI上表现为均匀的斑片状和结节状强化,无坏死,类似恶性淋巴瘤和转移瘤。1例表现为Lhermitte - Duclos病样的平行线性条纹(即“虎纹”外观)。尽管这3例患者的影像学表现与GBM不符,但病理诊断证实为小脑GBM。
部分经评估的小脑GBM病例未表现出幕上GBM常见的CT、MRI和PET表现,导致术前鉴别诊断存在相当大的困难。