目的：分析WHO Ⅰ级脑膜瘤各亚型MRI表现与病理学的关系，提高对脑膜瘤各亚型的诊断水平。材料和方法：收集手术并经病理证实的WHO Ⅰ级脑膜瘤131例，术前均行颅脑MR扫描，并对MRI表现进行分析，内容包括：T1WI信号强度、T2WI信号强度、瘤周水肿程度和肿瘤强化程度，分别给予量化，对照病理，行多样本秩和检验，P＜0.05有统计学意义。结果：WHO Ⅰ级脑膜瘤各亚型T1WI信号强度有统计学差异（χ2=30.4，P<0.001），各亚型T2WI信号强度有统计学差异（χ2=20.1，P<0.001），各亚型瘤周水肿程度无统计学差异（χ2=9.09，P=0.059），各亚型强化程度有统计学差异（χ2=47.2，P＜0.001）。结论：血管瘤型脑膜瘤易与其他亚型脑膜瘤鉴别；上皮型脑膜瘤次之；混合型脑膜瘤、纤维型脑膜瘤及砂粒体型脑膜瘤三者之间不易鉴别，但与血管瘤型脑膜瘤和上皮型脑膜瘤可鉴别。
Abstract
Objective: To review the relationship between MRI features and pathology in subtypes of WHO grade Ⅰ meningiomas, and to improve the skill in diagnosis. Methods: MRI features and pathology of 131 surgically treated WHO grade Ⅰ meningiomas were retrospectively reviewed. The MRI features of meningioma were analyzed, including signal intensity on T1-weighted and T2-weighted images, peritumoral brain edema, and degree of enhancement in contrast-enhanced MRI. These features were scored according to their criteria. The correlation between MR features and pathology was calculated by Kruskal-Wallis H test(P＜0.05）. Results: T1WI signal intensity in subtypes was statistically different(χ2=30.4, P<0.001), and T2WI signal intensity in subtypes was statistically different(χ2=20.1, P<0.001). Peritumoral brain edema in subtypes was not statistically different(χ2=9.09, P=0.059). Enhancement degree in subtypes was statistically different(χ2=47.2, P<0.001). Conclusion: The angiomatous meningioma is the easiest to be identified from other subtypes. The meningothelial meningioma is easier to be identified from other subtypes. Transitional, fibrous and psammomatous meningioma are hard to be identified from each other, but easier to be identified from angiomatous meningioma and meningothelial meningioma.
关键词
脑膜瘤 /
磁共振成像
Key words
Meningioma /
Magnetic resonance imaging
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参考文献
[1]Louis DN, Ohgaki H, Wiestler OD, et al. The 2007 WHO classification of tumors of the central nervous system[J]. Acta Neuropathol, 2007, 114(2): 97-109.
[2]Eister AD, Challa VR, Gilbert TH, et al. Meningiomas: MR and histopathologic features[J]． Radiology, 1989, 170(3): 857-862.
[3]杜笑松，刘起旺，薛雁山，等. 脑膜瘤几种亚型MRI表现与病理对照研究[J]. 中国临床医学影像杂志，2005，16（3）：121-124.
[4]侯刚强，张小静，熊伟，等. 血管瘤型脑膜瘤MRI表现及临床病理对照[J]. 实用放射学杂志，2011，27（2）：166-172.
[5]郭翠萍，张雪林，吕晓飞，等. 钙化性砂粒体脑膜瘤的CT和MRI诊断[J]. 临床放射学杂志，2011，30（1）：22-25.
[6]杨若晨，王长秋，鲁安怀，等． 脑膜瘤中砂粒体矿化研究[J]． 地学前缘，2008，15（6）：44-53.
[7]张晓楠，程敬亮，王斐斐，等. 纤维型脑膜瘤的磁共振成像表现[J]. 中国临床医学影像杂志，2013，24（2）：77-80.
[8]王永奇，殷玉梅，孟凡莲，等. 1H-MRS在脑膜瘤诊断及各亚型分型中的应用[J]. 实用放射学杂志，2011，27（10）：1469-1472.
[9]徐鹏，徐凯，吕璐璐. 血管瘤型脑膜瘤的常规MRI、DWI特征与病理基础[J]. 实用放射学杂志，2014，30（6）：911-913.
[10]谭兴实，王诚. 脑膜瘤瘤周水肿发生机制研究进展[J]. 中华神经外科疾病研究杂志，2011，10（2）：190-192.
[11]彭龙，侯庆石，周东. 脑膜瘤瘤周水肿机制研究进展[J]. 中国临床神经外科杂志，2012，17（3）：189-191.
[12]Liu Z, Wang C, Wang H, et al. Clinical characteristics and treatment of angiomatous meningiomas: a report of 27 cases[J]. Int J Clin Exp Pathol, 2013, 6(4): 695-702.
[13]Lee JW, Lee IS, Choi KU, et al. CT and MRI findings of calcified spinal meningiomas: correlation with pathological findings[J]. Skeletal Radiol, 2010, 39(4): 345-352.
