恶性脑膜瘤CT与MRI表现

CT and MR features of malignant meningioma

目的分析恶性脑膜瘤CT与MRI影像学表现,以提高其术前诊断准确率。方法回顾性分析18例经手术病理证实的恶性脑膜瘤CT与MRI影像学表现。结果 18例肿瘤中,大脑镰旁5例,大脑凸面4例,海绵窦旁3例,鞍上2例,鞍旁2例,小脑半球2例;边缘规整者4例,边缘分叶状者14例,肿瘤边缘清晰者2例,边缘模糊者16例;CT密度、T2WI信号不均匀者15例,内部可见囊变、坏死、出血。肿瘤强化显著,15例表现为不均匀强化,3例均匀强化,13例表现为短、粗不规则硬膜尾征;轻度水肿8例,中度水肿5例,重度水肿5例;临近颅骨破坏5例,2例形成软组织肿块并突向颅外,6例颅骨增生、硬化。结论恶性脑膜瘤具有特殊的影像学特征,正确分析其表现,有助于提高其术前诊断率。

Objective To analyze CT and MR features of malignant meningioma and to elevate the diagnostic accuracy. Methods CT and MR features of 18 cases with malignant meningioma proved by surgery were analyzed. Results As for location,5 cases were falcine meningiomas,4 cases at parietal areas,3 cases besides cavernous sinus,2 cases were on the sella turcica,2 cases besides sella turcica,2 cases in the cerebellar hemisphere;4 cases of them had regular edges,14 cases with irregular edges,2 cases with clear edge,16 cases with blur edge;15 cases presented uniform density,signal intensity,areas of cyst,necrosis,hemorrhage,formation can be seen.Malignant meningioma appeared as inhomogeneous enhancement in 15 cases,13 cases showed short and irregular ＂dural tail sign＂;8 cases slight,5 cases medium,and 5 cases heavy edema;5 cases displayed metastatic bony destruction,2 cases appeared as soft tissue mass and sudden formation to extracranial.Six cases of skull hyperplasia,hardening. Conclusion Malignant meningiomas have special features on CT and MRI,correct analysis of the performance can helpful to improving the preoperative diagnosis rate.