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目的探讨颅內胶质瘤柔脑膜扩散的MRI影像学特征,为临床治疗及估计预后提供参考。方法共搜集颅內胶质瘤245例,其中星形细胞瘤156例,多形成胶质细胞瘤89例。对其中具有柔脑膜扩散的40例胶质瘤的临床及MRI资料进行分析。结果 40例具有柔脑膜扩散的胶质瘤中,星形细胞瘤15例,多形成胶质细胞瘤25例,柔脑膜扩散发生率分别为9.6％和28.1％。颅內胶质瘤柔脑膜扩散男女发生率分别为16.9％和14.5％,经x~2检验,无显著性差异(P＞0.05)。胶质瘤柔脑膜扩散可发生在任何年龄,星形细胞瘤柔脑膜扩散在各年龄组间发生率无显著性差异(x~2=0.22,P＞0.05)；多形成胶质细胞瘤柔脑膜各年龄组间扩散发生率无显著性差异(x~2=1.496,P＞0.05)。原发肿瘤大小对胶质瘤扩散影响不大,各组间无显著性差异(x~2星形细胞廇=0.22,P＞0.05；x~2多形成胶质细胞瘤=1.496,P＞0.05)。胶质瘤柔脑膜扩散具有一定的特征性,在MRI上,颅内胶质瘤柔脑膜扩散有4种较为特征性的表现：结节征11例,条索征16例,曲线征9例,树枝征13例。结论 MRI能清晰地显示颅內胶质瘤柔脑膜扩散,可为临床治疗及估计预后提供有价值的信息。
Objective To investigate the MRI features of intracranial glioma spreading of meninges and provide reference for clinical treatment and prognosis. Methods A total of 245 cases of intracranial glioma were collected, including 156 cases of astrocytomas and 89 cases of gliomas. The clinical and MRI data of 40 glioma patients with diffuse cerebral lamina propria were analyzed. Results Among the 40 cases of gliomas with diffuse cerebral lamina propria, there were 15 cases of astrocytomas and 25 cases of pleomorphic gliomas. The incidence of leptomeningeal spread was 9.6% and 28.1% respectively. The incidence of intracranial glioma diffuse meninges were 16.9% and 14.5%, respectively. There was no significant difference (P> 0.05) after X-2 test. The spread of glomerulus in meninges could occur at any age. There was no significant difference in the incidence of diffuse astrocytoma between men and women in all age groups (x ~ 2 = 0.22, P> 0.05); polygamous meninges There was no significant difference in diffusion between different age groups (x ~ 2 = 1.496, P> 0.05). The size of the primary tumor had little effect on the proliferation of gliomas, and there was no significant difference among the groups (x ~ 2 astrocytoma 0. = 0.22, P> 0.05; x ~ 2 pleomorphic glioma = 1.496, P> 0.05 ). Glomerulus diffusion of meninges has a certain characteristic. On MRI, intracranial glioma, there are four more characteristic manifestations of leptomeningeal proliferation: nodules in 11 cases, stripping symptoms in 16 cases, 9 cases of curve symptoms, Tree sign in 13 cases. Conclusion MRI can clearly show the diffuse of intracranial glioma, which may provide valuable information for clinical treatment and prognosis.