脑膜瘤部位、大小及病理分型对瘤周水肿的影响

Influence of tumoral location,size and histology on peritumoral brain edema in intracranial meningiomas

目的:探讨脑膜瘤瘤周水肿(PTBE)与瘤体位置、大小及病理分型的关系.方法:对151例颅内脑膜瘤手术切除患者进行回顾性分析研究.术前利用CT或MR检查评估瘤体部位、体积及瘤周水肿指数(EI),术后进行脑膜瘤组织学分型.采用秩和检验和χ2检验对瘤周水肿指数与瘤体位置、体积及组织学分型进行比较.结果:前颅窝及中颅窝脑膜瘤PTBE发生率和EI较其他部位均增高(P<0.05);恶性脑膜瘤(WHO-Ⅲ)PTBE发生率和EI较典型脑膜瘤(WHO-Ⅰ)均升高,分别为81.8%vs57.8%(P<0.01),3.4vs2.5(P<0.01);纤维型脑膜瘤瘤周水肿EI较低,同分泌型和过渡型脑膜瘤相比,差别均具有统计学意义,分别为1.5vs7.4(P<0.01),1.5vs2.8(P<0.05);脑膜瘤体积在80cm3以下时肿瘤体积增加与PTBE的发生率增高有关,且肿瘤体积增大与EI降低有关.结论:脑膜瘤位置、大小及病理分型与PTBE的发生及程度密切相关.

AIM： To analyze the influence of tumoral location, size and histological types on peritumoral brain edema （PTBE） in intracranial meningiomas. METHODS： A retrospective study of 151 intracranial meningioma patients who underwent surgical removal of the tumor was performed. The tumor location, size and edema index were determined by computed tomography and （or） MRI. The histological types were determined post-operatively. The Wilcoxon test and X2-test were performed to evaluate the PTBE incidence and edema index. RESULTS： Frontobasal and temporobasal meningiomas showed a significant increase in the edema incidence and the edema index （ P 〈 0.05 ） ; WHO-Ⅲ- meningiomas showed a significantly higher edema incidence （81.8% vs57.8%, P〈0.001） and edema index （81.8% vs 57.8%, P 〈0.001 ） than WHO-I-meningiomas; Fibrous menin- giomas displayed a significantly lower edema incidence than secre- tory meningioma （ 1.5 vs 7.4, P 〈0.01 ） and transitional menin- giomas （ 1.5 vs 2.8, P 〈 0. 05 ）. An increasing tumor size was associated with an increasing PTBE incidence, but the edema index showed an inverse relationship to tumor size. CONCLUSION： There are close relationships among tumoral location, size, histological types and PTBE in intracranial meningioma.