The Application of Multiparametric MRI in the Diagnosis and Differentiation of Giant Cell Glioblastoma
Objective This study aimed to analyze the MRI findings of Giant Cell Glioblastoma to improve the understanding and diagnosis of this disease.Methods This study retrospectively collected the clinical and MRI data of 5 patients with cytomegaloblastic glioblastoma confirmed by surgery and pathology.The researchers summarized and analyzed the MRI findings of each case,including the location of lesions,different sequence signal characteristics,and invasion of tissues around the lesions.Results MRI showed that 4 patients with single lesion,3 cases were located in the right frontal lobe,and 1 case was in the left frontoparietal lobe.One patient with multiple lesions,which were located in the right frontotemporal insular lobe and basal ganglia.The tumors of 2 patients were solid,and the tumors of 3 patients were cystic.The tumor boundaries were clear in 3 cases and blurred in 2 cases.There were 2 cases of mild edema and 3 cases of moderate edema and there was 1 case of tumor hemorrhage.All 5 tumors on Dynamic Contrast Enhanced-MRI(DCE-MRI)showed significant uneven strengthening,and 3 of them had necrotic cystitis.The rCBV of the solid components of the masses in three patients significantly increased on Perfusion Weighted Imaging(PWI).In three patients with Diffusion Tensor Imaging(DTI),the ADCmin value of the solid part of the tumor significantly reduced,and the FA value of tumor and peritumor edema was significantly reduced.In 4 patients with Magnetic Resonance Spectroscopy(MRS),the Chocholine peak of the solid component of the tumor significantly increased.The Immunohistochemical Glial Fibrillary Acid Protein(GFAP)of all 5 patients was positive,and Ki-67 positive cells reached 20％～40％.Conclusion The incidence of giant cell glioblastoma is low,and relevant literature and case reports are limited.Multiparametric MRI has high value for tumor diagnosis,can help radiologists assess lesion size,location,signal characteristics,range of involvement and surrounding tissue changes,which is helpful for clinical preoperative evaluation,postoperative follow-up and efficacy evaluation.But there are shortcomings in differential diagnosis with classical glioblastoma.As the unique features of this rare malignancy continue to be explored,the diagnosis and treatment of GCG may be further improved.
万方数据
维普
