应用MRI基本特征预测非良性脑膜瘤的初步研究

Preliminary study on the prediction of non-benign meningiomas according to conventional magnetic resonance imaging features

目的评估根据术前影像学基本特征预测非良性(WHOⅡ~Ⅲ级)脑膜瘤的可行性。方法回顾性分析37例手术并经组织病理学确诊的大脑半球凸面脑膜瘤病例资料,根据2016版WHO中枢神经系统肿瘤分类方法进行组织学分型,使用Ki-67指数评价肿瘤增殖活性。术前MRI基本特征包括肿瘤的体积、边缘、骨侵袭、瘤-脑界面、硬脑膜尾征、瘤周脑水肿、强化效应、形态、瘤内出血、肿瘤基底、钙化、囊变、坏死等。Logistic回归分析影像学特征与脑膜瘤组织病理学性质及细胞增殖活性的关系。结果良性脑膜瘤27例(72.97%,27/37),Ki-67中位数3%,Ki-67≥10%9例(33.33%,9/27);非良性脑膜瘤10例(27.03%,10/37),Ki-67中位数15%,≥10%7例(70%,7/10)。Logistic回归分析显示:不规则形态是非良性脑膜瘤的独立危险因素,边缘毛糙是高增殖活性的独立危险因素。结论MRI有助于预测脑膜瘤的组织病理学性质与高增殖活性。

Objective To evaluate the feasibility of predicting non-benign(WHO gradeⅡ-Ⅲ)meningioma based on the basic characteristics of preoperative magnetic resonance imaging(MRI).Methods The data of 37 patients with pure cerebral convexity meningioma undergoing microsurgical operation and obtaining pathological diagnosis were analyzed retrospectively.The histological subtyping was performed according to the 2016 WHO classification of central nervous system tumors,and the Ki-67 index was used to evaluate tumor proliferation activity.The basic features of preoperative MRI included tumor volume,rim,skull invasion,tumor-brain interface,dural tail sign,peritumoral brain edema,enhancement,shape,intracranial hemorrhage,tumor base,calcification,cystic change or necrosis.Logistic regression analysis was used to explore the relationship between the imaging features and the histopathological grades or cell proliferation activity of meningiomas.Results The benign meningiomas were in 27 cases(72.97%,27/37),Ki-67 median was 3%,Ki-67≥10%in 9 cases(33.33%,9/27).The non-benign meningiomas were in 10 cases(27.03%,10/37),Ki-67 median was 10%,≥15%in 7 cases(70%,7/10).Logistic regression analysis showed that irregular shape was an independent risk factor for non-benign meningiomas,and rough margin was an independent risk factor for high proliferative activity.Conclusion MRI is valuable to predict the non-benign meningiomas and the meningiomas with high proliferative activity.