MRI多模态扫描在上皮样胶质母细胞瘤诊断中的应用

黎春艳; 徐海波

doi:10.14188/j.1671-8852.2024.0991

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MRI多模态扫描在上皮样胶质母细胞瘤诊断中的应用

肿瘤学研究 | 更新时间：2026-11-06

- MRI多模态扫描在上皮样胶质母细胞瘤诊断中的应用
- Application of MRI multiparametric imaging in the diagnosis of epithelioid glioblastoma
- 武汉大学学报（医学版） 2025年46卷第12期页码：1600-1604
- 作者机构：
  
  武汉大学中南医院放射科　湖北　武汉 430071
- 作者简介：
  
  徐海波，男，1963—，医学博士，主任医师，主要从事影像诊断、分子影像与脑功能成像的研究，E⁃mail:xuhaibo@whu.edu.cn
- 基金信息：
  
  国家自然科学基金资助项目(82271960)
- DOI：10.14188/j.1671-8852.2024.0991
  中图分类号： R739.41
- 收稿：2024-12-19，
  
  纸质出版：2025-12-25
- 稿件说明：
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黎春艳,徐海波.MRI多模态扫描在上皮样胶质母细胞瘤诊断中的应用[J].武汉大学学报（医学版）,2025,46(12):1600-1604.

XU Haibo.Application of MRI multiparametric imaging in the diagnosis of epithelioid glioblastoma[J].Medical Journal of Wuhan University,2025,46(12):1600-1604.
黎春艳,徐海波.MRI多模态扫描在上皮样胶质母细胞瘤诊断中的应用[J].武汉大学学报（医学版）,2025,46(12):1600-1604. DOI： 10.14188/j.1671-8852.2024.0991.

XU Haibo.Application of MRI multiparametric imaging in the diagnosis of epithelioid glioblastoma[J].Medical Journal of Wuhan University,2025,46(12):1600-1604. DOI： 10.14188/j.1671-8852.2024.0991.

摘要

目的

归纳上皮样胶质母细胞瘤（eGBM）的影像学特征，提高对该病的影像诊断水平。

方法

回顾性分析2016—2024年在武汉大学中南医院手术后经病理学检查证实的5例eGBM的临床和MRI资料，对影像学特征进行总结并复习相关文献。

结果

MRI结果显示病灶主体均位于幕上，额叶3例，颞叶1例，基底节区1例。病变边界清晰4例，边界模糊1例；4例轻度至中度水肿，1例重度水肿。增强扫描均呈不均匀强化伴片状无强化液化坏死区，其中3例呈环形强化。肿瘤实性增强部分DWI呈高信号、ADC呈低信号，伴Cho峰升高，NAA峰下降。免疫组织化学检测结果显示：GFAP阳性率80%（4/5），ATRX阳性率100%（4/4），IDH⁃1无突变（4/4），BRAF V600E基因突变率60%（3/5），Ki⁃67增殖指数10%~25%。

结论

上皮样胶质母细胞瘤的MRI影像学表现具有一定的特征，对于该病的术前诊断具有重要的指导意义。

Abstract

Objective

To analyze and summarize the MRI features of epithelioid glioblastoma (eGBM)

aiming to enhance the understanding and diagnostic accuracy of eGBM.

Methods

A retrospective analysis was conducted on the clinical and MRI data of five cases of eGBM

surgically treated and pathologically confirmed at Zhongnan Hospital of Wuhan University from 2016 to 2024. Imaging characteristics were summarized and relevant literature reviewed.

Results

MRI results revealed that the lesions were all located in the supratentorial region

with three cases in the frontal lobe

one in the temporal lobe

and one in the basal ganglia. Four cases exhibited well⁃defined lesion margins

while one case had indistinct margins. Peritumoral edema was classified as mild to moderate in four cases and severe in one. All dynamic contrast⁃enhanced MRI (DCE⁃MRI) scans demonstrated heterogeneous enhancement with areas of non⁃enhancing liquefactive necrosis

and three cases showed ring⁃like enhancement. The solid components of the tumor exhibited a high signal on DWI and a low signal on ADC

accompanied by an elevated choline peak and a decreased NAA peak. Immunohistochemical analysis showed that the positive rate of glial fibrillary acidic protein (GFAP) was 80% (4/5)

ATRX was positive in all 4 cases examined

no IDH⁃1 mutations were detected (4/4)

BRAF V600E mutations were present in 60% (3/5)

and the Ki⁃67 proliferation index ranged from 10% to 25%.

Conclusion

MRI features of epithelioid glioblastoma are characteristic and important for preoperative diagnosis.

关键词

Keywords

references

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