Abstract:Objective To study the clinical and imaging characteristics of glioma of the insula and insula cap, to make early diagnosis and to improve the treatment effect. Methods A retrospective study was conducted on 19 cases of glioma of the insula and insula cap misdiagnosed among 312 cases of glioma treated by surgery within 5 years, and the patients were followed up. Results CT showed low density lesions in the insula and the frontal, temporal and parietal insular cortex. MRI suggested T1 low-signal areas, T2 high-signal areas in the frontal, temporal and parietal insular areas and the insula and high signal areas in the cerebral cortex of the circumflex lateral sulcus vessels on the Flair image, with no obvious borders and typical tumor mass, and without obvious displacement of the midline. Under the microscope during the operation, the tumor tissue grew in the subchondrium of the frontal lobe, temporal lobe, parietal insula and the surface of the insula or/and broke through the subchondrium to the subarachnoid space, and eroded the cortex. The tumor was grayish-white or grayish-purple in color, and was soft and easy to be removed by suction, and the boundary with the normal tissues was blurring, and the tumor did not have rich blood supply, and the arterial vessels could be seen deeply penetrating into the normal cerebral tissues and supplying blood to the normal cerebral tissues after the resection of the tumor. After surgery, the pathology report showed astrocytoma grade Ⅰ~Ⅱ or astrocytoma to oligodendroglioma grade Ⅰ~Ⅱ. After surgery, CT or MRI showed that the tumor was completely resected in 13 cases, largely resected in 4 cases and partially resected in 2 cases. Epileptic symptoms and headache symptoms disappeared in 15 cases, improved in 3 cases, and 1 patient showed increased weakness of the contralateral lower limb after surgery. All patients were followed up, only 1 case was lost, the follow-up period was from 6 months to 3 years and 4 months, there were no new signs and symptoms, and 2 cases of tumor recurrence were detected by imaging examination. All patients were able to lead a normal life, and 11 patients resumed normal work. Conclusion: Gliomas of the insula and insula cap have their unique history and imaging characteristics, and their evolution can be correctly diagnosed and early surgery can achieve good therapeutic effect.