恶性脑膜瘤的CT、MR及病理研究

CT、MR and pathological features of malignant meningiomas

目的 :探讨恶性脑膜瘤CT、MR表现及其病理学特点。方法 :分析 11例经临床和病理证实的恶性脑膜瘤CT、MR表现及其病理学改变。探讨CT、MRI诊断恶性脑膜瘤的临床价值。结果 :11例恶性脑膜瘤中 ,顶部镰旁 4例 ,额部镰旁 3例 ,颞极 1例 ,大脑凸面 3例。边缘光滑者 4例 ,边缘呈不规则分叶状者 7例 ;密度及信号均匀者 4例 ,混杂密度及信号者 7例 ,内部可见囊变、坏死。灶周无水肿 2例 ,轻度水肿 2例 ,中度水肿 4例 ,重度水肿 3例 ;增强后见硬膜尾征 4例 ,形态光整 1例 ,结节状增厚 3例 ;邻近颅骨破坏 3例 ;1例胸腰椎多发转移 ,骨质破坏。结论 :恶性脑膜瘤CT、MRI具有较为特殊的影像学特点。术前正确认识其表现 ,有助于制订手术方案。

Objective:To study CT,MR and pathological features of malignant meningioma.Methods:CT and MR manifestations of meningioma Ⅱ,Ⅲ(n=4,7 respectively) were analyzed and compared with pathological features.Results:As for location,7 were falcine meningiomas,4 of them at frontal areas,3 at parietal areas,1 at temporal bottom.3 at brain convexity.4 of them had regular edges,7 with irregular edges. 4 presented uniform density ,signal intensity and homogeneous enhancement.7 with mixed density and inhomogeneous enhancement,cystic and necrosis changes could be seen post-enhance contrast.2 were none surronding-edema, the others included 2 slight, 4 medium, and 3 heavy edema. 4 showed “dural tail sign”, 1 was regular, 3 thickened irregularly.The skull nearby were invasive in 3 cases.1 displayed metastatic bony destruction.Conclusion:Malignant meningiomas have special features on CT and MRI, it helps recognize correctly preoperatively.