Kelly P J, Daumas-Duport C, Scheithauer B W, Kall B A, Kispert D B
Mayo Clin Proc. 1987 Jun;62(6):450-9. doi: 10.1016/s0025-6196(12)65470-6.
In 39 patients who harbored previously untreated astrocytomas (21 patients), oligoastrocytomas (9 patients), or oligodendrogliomas (9 patients), computed tomographic (CT) and magnetic resonance imaging (MRI) findings were correlated with stereotactic serial biopsy findings. The 39 patients were classified as having one of three types of tumor: type I (1 patient), which consisted only of circumscribed tumor tissue; type II (26 patients), which consisted of tumor tissue and isolated tumor cells; or type III (11 patients), which consisted of intact parenchyma infiltrated by isolated tumor cells. (In one patient, the biopsy sampling was inadequate for determining the type of tumor.) In high-grade lesions, tumor tissue was obtained from CT contrast-enhancing regions, and the area of enhancement accurately defined the tumor tissue volume. In low-grade lesions, tumor tissue was hypodense and indistinguishable from parenchyma infiltrated by isolated tumor cells on both CT and MRI. Isolated tumor cells usually extended as far as the prolongation of T2 on T2-weighted MRI of high-grade and low-grade tumors. CT and MRI detection of boundaries and stereotactic serial biopsies are necessary for the demarcation of glial neoplasms into tumor tissue and isolated tumor cell volumes as well as for the determination of the spatial extent of each component. This information is important for determining appropriate treatment.
在39例曾患未经治疗的星形细胞瘤（21例）、少突星形细胞瘤（9例）或少突胶质细胞瘤（9例）的患者中，将计算机断层扫描（CT）和磁共振成像（MRI）结果与立体定向系列活检结果进行了对比。这39例患者被分为三种肿瘤类型之一：I型（1例），仅由边界清楚的肿瘤组织构成；II型（26例），由肿瘤组织和孤立的肿瘤细胞构成；或III型（11例），由被孤立肿瘤细胞浸润的完整实质构成。（1例患者的活检样本不足以确定肿瘤类型。）在高级别病变中，肿瘤组织取自CT增强区域，增强区域准确界定了肿瘤组织体积。在低级别病变中，肿瘤组织密度减低，在CT和MRI上均与被孤立肿瘤细胞浸润的实质难以区分。孤立的肿瘤细胞通常在高级别和低级别肿瘤的T2加权MRI上延伸至T2延长处。CT和MRI对边界的检测以及立体定向系列活检对于将胶质肿瘤划分为肿瘤组织和孤立肿瘤细胞体积以及确定每个成分的空间范围是必要的。这些信息对于确定合适的治疗方法很重要。
