关键词: 弥漫性中线胶质瘤, H3K27改变, 动脉自旋标记, 磁共振成像

Abstract: Objective To analyze and summarize the MRI features of diffuse midline glioma with H3 K27 altered, and help us improve the rate of diagnosis.Methods The clinical and imaging data of 20 patients with diffuse midline glioma with H3 K27altered confirmed by postoperative pathology were retrospectively analyzed, and the imaging manifestations such as the location, shape and enhancement characteristics, etc.of the tumor were observed.Results Among 20 patients, 5 lesions located at thalamus, of which 3 cases involved the ventricle wall or brain lobe, 8 lesions located in brainstem, 1 case located in the third ventricle, and 3 case located in the midline and involved multiple brain lobes, 3caseslocatedinthethoracicandlumbarspinalcord.9 lesions had round-shaped and clear borders;11 lesions were irregular in shape with unclear borders.The cases showed slightly lower or equal signal onT1WI, and equal or slightly higher signal onT2WI;12 lesions had different degrees of necrosis or cystic transformation, and 5 cases showed bleeding;7cases had mild to moderate edema around the tumor, and 13 cases had no obvious edema around the tumor.5cases of hydrocephalus of varying degrees.T1WI enhancement :14 lesions showed uneven and obvious enhancement, of which 9lesionshad obvious enhancement in large or small rings, 5 cases had mild to moderate enhancement, and 1 case had no obvious enhancement.7 caseswith DWIshowed that 4 cases were slightly high signal, and 3 cases were uneven and obvious high signal.6 cases with ASL examination showedthesolidcomponent of tumor had high perfusion.4caseswith MRS showed prominent choline(CHO)and low N-acetyl aspartate(NAA) compared to the normal, and CHO/NAA ratio increased.Conclusion The appearance of diffuse midline glioma with H3 K27alteredonMRIshowed a certain specificity, which maybe helpful to improve the level of preoperative diagnosis.

Key words: Diffusemidline glioma, H3 K27altered, Arterial spin labeling, Magnetic resonance imaging