History: Adolescent male presents with progressive right arm weakness and gait abnormality.(青年男性右臂无力伴步态异常)
Pathology: Ganglioglioma(病理:神经节细胞胶质瘤)
Ganglioglioma of the cervical cord
(颈髓神经节细胞胶质瘤)
Gangliogliomas are rare tumors of the central nervous system, comprised of mixed neuronal and glial elements. They occur most frequently in the pediatric population or young adulthood. Usually found in the hemispheres, they may occur in the posterior fossa and rarely also in the spine.(神经胶质瘤是中枢神经系统少见肿瘤,由混合神经元和胶质成份构成。他们最常发生在儿童或青年。通常在大脑半球,它们可能出现在后颅窝,也很少出现在脊柱中。)
When ganglioglioma occurs in the spinal cord, these slow growing tumors are usually accompanied by syringomyelia and syringobulbia. The tumors often have a cystic component, but may be solid. The tumor may involve multiple spinal levels or sometimes even the entire cord,the patient may present with scoliosis.(在脊髓神经节胶质细胞瘤发生时,生长缓慢的肿瘤通常伴有脊髓空洞症和延髓空洞症。肿瘤通常有囊性成分,也可能是实性。肿瘤可能累及多个脊髓水平,有时甚至累及整个脊髓,患者可能出现脊柱侧弯。)
再让我们通过下面几例病例巩固一下脊髓神经节细胞胶质瘤的影像表现。(以下病例均摘自丁香园)
病例1:男孩,16 岁,右侧颈部,上肢和胸部异常出汗 6 年余。行 MRI 检查结果如下。
胸椎 MRI 检查结果显示:T2~3 椎体水平脊髓内见一梭型等长 T1(A)长 T2(B)异常信号,强化后(C)未见明显强化。轴位图像显示病变位于脊髓的右侧份。病理结果为髓内节细胞胶质瘤(WHO I)
病例2:14 岁女孩,上背部疼痛 6 各月,仰卧位加重。行 MRI 检查结果如下。
颈椎 MRI 检查结果显示 C2~T2 椎体水平脊髓肿胀,其内可见混杂异常 T2WI(a),轴位(b)可见异常强化。病理结果为脊髓节细胞胶质瘤(间变型)
病例3:三例脊髓节细胞胶质瘤并伴有脊柱侧弯。
三例脊髓节细胞胶质瘤无明显特异性 MR 特征,脊髓肿胀,部分椎体受累,均伴有脊柱侧弯。
脊髓节细胞胶质瘤 MRI 检查无特异性,对其明确诊断较为困难。在诊断髓内占位性病变时,若为青少年患者,病变 T1WI 及 T2WI 均呈不均匀信号,累及脊髓范围较广,呈膨胀生长,增强扫描呈斑片状或脊髓表面强化时应考虑脊髓节细胞胶质瘤可能,若有钙化则更加支持该诊断。(摘自《放射学实践》儿童脊髓节细胞胶质瘤一例,作者:王金星等)
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