非脑膜瘤脑膜异常强化的MRI与病因对比研究

Non meningioma abnormal meningeal enhancement on MRI: a correlative study between MRI and clinical disorders

目的：分析不同脑膜病变的强化特征，探讨脑膜强化形式与病因诊断的关系。材料与方法：回顾性分析资料完整的异常脑膜强化２６例，根据脑膜受累层次、范围将强化形式分为四种：（１）弥漫性脑膜强化；（２）弥漫性硬膜强化；（３）弥漫性软膜强化；（４）局限性硬膜强化。依病因不同将脑膜病变分为三组：（１）肿瘤组；（２）炎症组；（３）反应组。结果：２６例中，肿瘤组８例，其中弥漫性硬膜、软膜强化各３例，弥漫性脑膜强化、局限性硬膜强化各１例。炎症组８例，弥漫性软膜强化７例，局限性硬膜强化１例。反应组１０例，８例呈局限性硬膜强化，２例呈弥漫性硬膜强化。结论：不同的脑膜病变可表现不同的强化特征，但离开临床，仅根据强化特征尚难做出定性诊断。

Purpose: To analyze the patterns of meningeal enhancement in different pathologic meningeal processes and probe the relationship between enhancing patterns and etiologic diagnoses. Materials and methods: Twenty six patients with abnormal meningeal enhancement were retrospectively analyzed. According to the different layers and extent affected, the enhancing patterns were divided into four types: diffuse meningeal, diffuse dural, diffuse leptomeningeal, and focal dural enhancement. On the basis of etiologic difference, meningeal disorders were classified into 3 groups: carcinomatous, inflammatory, and reactive. Results:8 of 26 cases had carcinomatous, of which 3 diffuse dural, 3 diffuse leptomeningeal, 1 diffuse meningeal and 1 focal dural enhancement. Eight had inflammatory etiology, among which 7 diffuse leptomeningeal, 1 focal dural enhancement. 10 of them were reactive, of which 8 focal dural and 2 diffuse dural enhancement. Conclusion: Various disease processes may have distinct enhancing patterns on gadolinium enhanced MR imaging, however, it is still hard to make accurate diagnosis via enhancing patterns only.