Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Biomed Res Int. 2020 Oct 16;2020:9586806. doi: 10.1155/2020/9586806. eCollection 2020.
The MRI features of epithelioid glioblastoma (eGBM) were analyzed. The apparent diffusion coefficient (ADC), MR perfusion-weighted imaging (PWI), and magnetic resonance spectroscopy (MRS) findings were quantitatively analyzed.
The MRI images of 8 cases of eGBM were analyzed retrospectively. The location and edge, signal, peritumoral edema, adjacent meningeal invasion, and enhancement of the lesions were observed. The ADC value, relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), and N-acetylaspartate/acetylcholine (NAA/Cho) value were analyzed.
Among the 8 patients, the tumors were mainly located in the temporal lobe ( = 3), frontal lobe ( = 3), and parietal lobe ( = 2). The lesion boundary was clear in 6 cases and unclear in 2. The lesions were superficial in 5 cases and in the deep white matter in 3. Internal hemorrhage was observed in 4 cases. There was cystic necrosis in 7 cases, and only 1 case was solid without cystic necrosis. There was no edema around the lesion in 1 case, severe edema in 5, and moderate edema in 2. In 4 cases, the adjacent meninges were involved, and in 1 case, the ependyma was involved. Two patients developed leptomeningeal metastasis within 2 months after the operation. The average ADC value of the tumor parenchyma among all 8 patients was7.15 × 10 mm/s,which was 17.6% lower than that of the contralateral side. The Cho/NAA metabolite ratio was 5.27 and 0.81 in the lesions of 2 patients. The rCBV was 3.51 ml/100 g and 3.32 ml/100 g of lesions in 2 patients; these values were 36% and 29% higher, respectively, than those of the contralateral side. The rCBF was 31.5 ml/100 g/min and 82.1 ml/100 g/min of lesions in two patients; these values were 49% and 203% higher, respectively, than those of the contralateral side.
eGBM characteristics include a superficial location, easy cyst degeneration, easy necrosis and hemorrhage, and clear boundaries. It easily invades adjacent meninges and shows cerebrospinal fluid dissemination and metastasis. Combining new MR techniques, such as ADC values, PWI, and MRS, could be helpful for improving diagnostic accuracy.
分析上皮样胶质母细胞瘤（eGBM）的 MRI 特征。对表观扩散系数（ADC）、磁共振灌注加权成像（PWI）和磁共振波谱（MRS）的表现进行定量分析。
回顾性分析 8 例 eGBM 患者的 MRI 图像。观察病变的位置和边缘、信号、瘤周水肿、邻近脑膜侵犯和强化。分析 ADC 值、相对脑血容量（rCBV）、相对脑血流量（rCBF）和 N-乙酰天门冬氨酸/乙酰胆碱（NAA/Cho）值。
8 例患者中，肿瘤主要位于颞叶（=3）、额叶（=3）和顶叶（=2）。6 例边界清楚，2 例边界不清楚。5 例病变位于表浅部位，3 例位于深部白质。4 例可见内部出血。7 例有囊变坏死，1 例为实性无囊变坏死。1 例病变周围无水肿，5 例水肿严重，2 例水肿中度。4 例邻近脑膜受累，1 例室管膜受累。2 例患者术后 2 个月内发生软脑膜转移。8 例患者肿瘤实质的平均 ADC 值为 7.15×10 mm/s，比对侧低 17.6%。2 例患者病变的 Cho/NAA 代谢物比值分别为 5.27 和 0.81。2 例患者的 rCBV 分别为 3.51 ml/100 g 和 3.32 ml/100 g，分别比对侧高 36%和 29%。2 例患者病变的 rCBF 分别为 31.5 ml/100 g/min 和 82.1 ml/100 g/min，分别比对侧高 49%和 203%。
eGBM 的特征包括位置表浅、易发生囊变、易发生坏死和出血，边界清楚。易侵犯邻近脑膜，表现为脑脊液播散和转移。结合 ADC 值、PWI 和 MRS 等新的磁共振技术，有助于提高诊断准确性。
