Gd-DTPA造影增强MRA诊断脑膜瘤的初步研究

GdDTPA Enhancement MR Angiography in Meningioma

目的：评价Ｇｄ－ＤＴＰＡ造影增强ＭＲＡ诊断脑膜瘤，特别是显示肿瘤血运情况的价值。材料与方法：４８例脑膜瘤患者行增强ＭＲＡ检查，其中２５例经手术病理证实，男８例，女１７例，男女之比为１２．３。年龄３６～７２岁，平均５４±１１岁。应用１．０Ｔ磁共振成像机（ＳｉｅｍｅｎｓＩｍｐａｃｔ），Ｇｄ－ＤＴＰＡ为磁显葡胺和／或马根维显，剂量０．１ｍｍｏｌ／ｋｇ，静脉团注后１０～１５分钟内行三维ＴＯＦ脑ＭＲＡ检查，以ＭＩＰ法重建图像。另外，１０例患者仅行平扫ＭＲＡ检查，作为对照组。结果：２５例患者显示２８个脑膜瘤，最小为１．２ｃｍ×１．２ｃｍ×１．４ｃｍ，最大达７．２ｃｍ×７．８ｃｍ×８．１ｃｍ，均有明显肿瘤染色。２７个肿瘤（９６％）主要由颈外动脉的分支供血，其中６个有“双重供血”。２５个肿瘤（８９．３％）显示引流静脉及其引流途径，２个肿瘤直接累及静脉窦。２１个肿瘤（７５％）显示脑内动脉及其分支有不同程度的移位。而对照组仅１个肿瘤显示轻度肿瘤染色，４个（４０％）显示脑内动脉及其分支的移位。结论：增强ＭＲＡ显示脑膜瘤的血运情况与术中所见相符，能代替Ｘ线脑血管造影行精确术前诊断，值得推广应用。

Objective: To evaluate the diagnostic value and limit of GdDTPA enhancement MR Angiography (MRA) in meningioma.Materials and Methods:48 patients with meningioma were studied by GdDTPA enhancement (0.1mmol/kg) 3DTOF MIP reconstruction MRA, in which the diagnosis of 25 patients (male 8, female 17) were corroborated by operation and pathology. 10 patients with meningioma were studied by MRA without GdDTPA as Control Group.Results:28 tumors were detected in 25 cases. The tumordye was found in 100%, and the feeding arteries of tumor coming from the branches of external carotid artery were seen in 96%, among of them 6 cases with dual feeding arteries and draining veins of tumor as well as their drainage way were demonstrated in 89.3%, and the displacement of cerebral vessel in vary degrees could be easily depicted in 75%, on GdDTPA enhancement MRA. MRA without GdDTPA showed the displacement of cerebral vessel in 40% only, and could not demonstrate other signs.Conclusion: GdDTPA enhencement MRA is useful method for showing blood circulation condition of meningioma, and coincide within operation.