Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea.
Section for Computational Neuroimaging, Department of Neuroradiology, Heidelberg University College of Medicine, Heidelberg, Germany.
J Magn Reson Imaging. 2023 Sep;58(3):677-689. doi: 10.1002/jmri.28743. Epub 2023 Apr 17.
The fifth edition of the World Health Organization (WHO) classification of central nervous system tumors published in 2021 advances the role of molecular diagnostics in the classification of gliomas by emphasizing integrated diagnoses based on histopathology and molecular information and grouping tumors based on genetic alterations. Importantly, molecular biomarkers that provide important prognostic information are now a parameter for establishing tumor grades in gliomas. Understanding the 2021 WHO classification is crucial for radiologists for daily imaging interpretation as well as communication with clinicians. Although imaging features are not included in the 2021 WHO classification, imaging can serve as a powerful tool to impact the clinical practice not only prior to tissue confirmation but beyond. This review represents the first of a three-installment review series on the 2021 WHO classification for gliomas, glioneuronal tumors, and neuronal tumors and implications on imaging diagnosis. This Part 1 Review focuses on the major changes to the classification of gliomas and imaging findings on adult-type diffuse gliomas. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 3.
2021 年发布的第五版世界卫生组织（WHO）中枢神经系统肿瘤分类通过强调基于组织病理学和分子信息的综合诊断以及基于遗传改变的肿瘤分组，推进了分子诊断在神经胶质瘤分类中的作用。重要的是，提供重要预后信息的分子生物标志物现在是确定神经胶质瘤肿瘤分级的一个参数。对于放射科医生来说，了解 2021 年 WHO 分类对于日常影像学解读以及与临床医生的沟通至关重要。尽管影像学特征未包含在 2021 年 WHO 分类中，但影像学可以作为一种强大的工具，不仅在组织确认之前，而且在组织确认之后，影响临床实践。这是关于成人弥漫性神经胶质瘤、神经胶质神经元肿瘤和神经元肿瘤的 2021 年 WHO 分类以及对影像学诊断的影响的三部分综述系列中的第一部分。本部分重点介绍神经胶质瘤分类的主要变化以及成人型弥漫性神经胶质瘤的影像学发现。证据水平：3. 技术功效：第 3 阶段。
