Clinical,MRI and pathological features of supratentorial primitive neuroectodermal tumors / 临床神经病学杂志

ABSTRACT

Objective To investigate the clinical,MRI and pathological features of supratentorial primitive neuroectodermal tumor(PNET).Methods The clinical manifestations of 21 PNET patients were analyzed,the skull imaging examination were taken,including MRI with diffuse weighing imaging(DWI) and measured apparent diffusion coefficient(ADC) of tumor and its edema zone before surgery.After operation,the brain tumor tissues were routine and immunohistochemical staining.The relationship between the histopathologic changes and ADC were analyzed.Results In the group,the age of onset of 11cases(52%) were below 20 years old.Clinical manifestation include headache,dizziness and vomiting(16 cases),visual disorder(5 cases),dysosphresis or epilepsy(3 cases).MRI showed single PNET lesion in all the cases and which located at each brain region,the most of them were located at frontal,temporal,parietal lobes(18 cases),and could growing to cross a brain region.MRI T1WI showed that the lesions were iso-signal and lowiso-signal in 15 cases,interspersed high signal in 6 cases.T2WI showed that the lesions were iso and high mixed signal companing capsule change and necrosis,4 cases with lighter tumor edema,5 cases with vascular air flow sign.The imaging enhanced tumors showed uneven enhancement,and 4cases with meningeal tail sign.The pathological examination showed that PNET cell form was main differentiated to neuron(10 cases) and neuroglia(8 cases).There was no statistical significance between ADC and different cell differentiation.Immunity histochemistry showed that the positive of NSE,Syn and GFAP were more offen.Conclusions In the group,the age of onset is below 20 years old.Manifestations of supratentorial PNET are intracranial pressure incresing,visual disorder and dysosphresis.MRI features are mixed isgnal,vascular air flow sign and meningeal tail sign in the tumor.The tumor edema is lighter.The tumor is differentiation mainly toward nerurons and neuroglias in the pathology.There is no positive relationship between ADC and types of tumor differentiation.