脑胶质瘤治疗后假性进展与复发的影像学鉴别研究进展

脑胶质瘤源自于神经上皮细胞,是颅内最常见的原发性肿瘤,其治疗方案为手术切除及后续的同步放化疗,但多达30%的患者会出现新的磁共振成像内的强化病变,这可能不是早期肿瘤进展(early progression,EP),而是放化疗导致的假性进展(pseudo-progression,PSP)。假性进展由于病变较轻且预后较好,只需对其进行对症治疗,而肿瘤复发时临床医生对其处理方式与假性进展不同,复发可能要选择再次手术或者使用放化疗等其他治疗方式,因此,如果胶质瘤的假性进展与复发被误诊,患者的最佳治疗时机将会受到耽误。常规磁共振成像不可能可靠地区分PSP和EP,目前一些更先进的成像方法有望对其进行准确鉴别。

Advances in imaging differentiation of pseudoprogression and recurrence of brain gliomas after treatment

Glioma,which originates from neuroepithelial cells,is the most common primary tumor in the brain.Its treatment is surgical resection and subsequent simultaneous radiotherapy and chemotherapy,but up to 30%of patients will develop new enhanced lesions in magnetic resonance imaging.This may not be the early tumor progression,but the pseudo progression caused by radiotherapy and chemotherapy Pseudoprogression,due to mild lesions and good prognosis,only needs symptomatic treatment,while tumor recurrence requires re-surgical treatment or other treatment options.If the tumor recurrence and false progression are misdiagnosed,it is likely to delay the best treatment time for patients,and eventually lead to ineffective diagnosis and treatment.Therefore,the correct distinction between recurrence and pseudoprogression of glioma patients is very important for the choice of clinical treatment.It is impossible for conventional magnetic resonance imaging to reliably distinguish PSP from EP.At present,some more advanced imaging methods are expected to identify them accurately.