title: [Neuroimaging diagnosis and therapeutic efficacy of different surgical methods of gliomatosis cerebri].
abstract: OBJECTIVE
  To explore the neuroimaging diagnosis and therapeutic efficacy of different surgical methods of gliomatosis cerebri.
  
  
  METHODS
  26 cases of gliomatosis cerebri at our department between September 2008 and September 2013 were retrospectively analyzed. Preoperative cranial computed tomography (CT), magnetic resonance imaging (MRI) and other multimodal imaging scans were performed. The procedures included stereotactic brain biopsy (n = 11) and large craniotomy lobotomy (n = 15). Whole brain radiotherapy and/or temozolomide therapy was performed postoperatively according to the malignancy of tumors. Follow-ups were conducted to analyze the survival differences between stereotactic brain biopsy and large craniotomy lobotomy groups.
  
  
  RESULTS
  According to the different features of multimodal imaging, gliomatosis cerebri could be divided into two types: (1) type I(n = 19) showed a diffuse infiltrating lesion infringing multiple brain lobes or regions with central corpus callosum but without obvious enhancement; (2) type II (n = 7) appeared as sporadic or tuberous enhancement in addition to the features of type I. Pathological diagnosis: pilocytic astrocytoma (n = 2), diffuse astrocytoma (n = 13), oligodendroglial tumors (n = 3), oligoastrocytoma (n = 1), anaplastic astrocytoma (n = 5) and glioblastoma (n = 2). The degree of malignancy was a prognostic factor for postoperative survival in patients with gliomatosis cerebri. The mean survival time (MST) of large craniotomy lobotomy group (23 ± 7) was significantly longer than that of stereotactic brain biopsy group (13 ± 3) (P < 0.05).
  
  
  CONCLUSIONS
  Gliomatosis cerebri is a primary brain glial tumor with diffuse infiltrative growth but retaining the general structure of central nervous system. Multimodal imaging studies plus pathological examination yield a definitive diagnosis. Comprehensive treatment of operation plus chemo- or radio-therapy can prolong postoperative MST.
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Ruobing
authors.initials: R
authors.lastname: Qian
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Xiangpin
authors.initials: X
authors.lastname: Wei
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Shiying
authors.initials: S
authors.lastname: Ling
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Xianming
authors.initials: X
authors.lastname: Fu
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China.
authors.forename: Yehan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei 230001, China. Email: niuchaoshi@163.com.
authors.forename: Chaoshi
authors.initials: C
authors.lastname: Niu
mesh_terms: D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis*; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed