脑膜瘤瘤周水肿相关因素研究

Analysis on the related factors in peritumoral brain edema of meningiomas

目的从影像学和病理学角度研究影响脑膜瘤瘤周水肿的因素。方法收集103例首发脑膜瘤的头颅磁共振、病理学资料、32例脑血管造影资料,根据磁共振资料计算获得脑膜瘤瘤周水肿指数。分别研究肿瘤大小、部位、病理类型、肿瘤与脑组织间蛛网膜下腔间隙是否消失、脑皮层血管是否参与肿瘤供血对脑膜瘤瘤周水肿指数的影响。结果瘤周水肿指数与肿瘤大小无关,与其它研究因素相关。相关因素中,脑组织间蛛网膜下腔间隙是否消失和脑皮层血管是否参与肿瘤供血这两个因素与瘤周水肿指数关系更密切。结论肿瘤与脑组织间蛛网膜下腔间隙消失和脑皮层血管参与脑膜瘤供血是形成脑膜瘤瘤周水肿的重要因素。

Objective Meningiomas may be associated with extensive peritumoral brain edema （PTBE） on MRI. The study aims to probe into the radiological and pathological factors influencing the development of PTBE. Methods A total of 103 patients with intracranial meningiomas were studied. Numbers of the edema index （ EI = （Vedema ＋ Vturoor ）/Vturoor ） were used as the extent of PTBE, which were obtained from the size of the meningiomas and the associated PTBE on contrast enhancement and T2-weighted （or FLAIR ） images of MRI. The relationship between El and some factors was evaluated, which may play a role in the development of PTBE. The factors included tumor size, tumor location, tumor pathology, arachnoid layer between tumor and brain, and vascular supply from intrinsic cerebral arteries, which was observed in digital subtraction angiography. Results A negative correlation （P = 0. 3615） was found between the size of the tumor and the volume of PTBE. The other factors were positively related with El of PTBE. Convexity, middle fossa and sphenoid meningiomas exhibited higher EIs than those in other positions. Meningothelial, atypical, and angiomatous subtypes had higher EIs. Disappearance of arachnoid layer and vascular supply from intrinsic cerebral arteries were mere important factors. Conclusion Disappearance of the arachnoid layer on magnetic resonance imaging scans and vascular supply from intrinsic cerebral arteries axe vital factors contributing to the peritumeral edema of meningiomas.