摘要：

目的 探讨胚胎发育不良性神经上皮肿瘤的MRI分型与癫癎预后的关系。方法 选择2012年1月至2019年7月经术后病理证实的14例胚胎发育不良性神经上皮肿瘤患者，收集其临床、影像、病理以及随访资料，分析影响其癫癎预后的相关因素。结果 14例患者均以癫癎发作起病，MRI分型8例为Ⅰ型，4例为Ⅱ型，2例为Ⅲ型。14例患者均经手术全切除肿瘤。术后病理HE染色均见特异性神经元成分，13例行免疫组化染色患者突触素、少突胶质细胞转录因子2和神经元核抗原均为阳性。术后随访6~84个月，MRI分型Ⅰ型患者术后癫癎发作控制达EngelⅠ级；Ⅱ型患者2例术后癫癎发作控制达EngelⅠ级，2例达EngelⅢ级；Ⅲ型患者2例术后癫癎发作控制均达EngelⅡ级。结论 胚胎发育不良性神经上皮肿瘤切除术后癫癎预后可能与MRI分型相关，MRI分型Ⅰ型患者较Ⅱ型和Ⅲ型患者术后癫癎预后更好。

关键词: 肿瘤,神经上皮, 磁共振成像, 癫癎

Abstract:

Objective To explore the relationship between MRI types and epilepsy control following tumor removal of dysembryoplastic neuroepithelial tumor (DNT). Methods The clinical and follow-up data of DNT cases were retrospectively collected from January 2012 to July 2019, and the data were further analyzed with respect to prognostic factors. Results Epilepsy occurred in all cases. According to MRI-based classification, 8 patients belonged to typeⅠ, 4 patients were typeⅡ, and the other 2 patients were type Ⅲ. Tumor total removal was performed in all cases. Postoperative pathological HE staining confirmed each tumor simple contained specific neuronal components in all cases, and in 13 cases, synaptin (Syn), oligodendrocyte transcription factor 2 (Olig-2) and neuronal nuclear antigen (NeuN) were positive in routine immunohistochemical staining. In the postoperative follow-up period from 6-84 months, Engel Ⅰ outcome was achieved in all typeⅠ cases and 2 type Ⅱ cases, Engel Ⅲ was in 2 type Ⅱ cases, Engel Ⅱ was in 2 type Ⅲ cases. Conclusions Postoperative seizure control in PNT may be closely associated with the MRI types, and type Ⅰ may have a better prognosis in seizure control following tumor removal than typeⅡand typeⅢ.

Key words: Neoplasms,neuroepithelial, Magnetic resonance imaging, Epilepsy