大脑凸面小型脑膜瘤瘤周水肿的MRI表现与其病理亚型的关系

MRI findings of peritumoral edema in convex surface small meningioma and its pathological subtypes

目的利用磁共振成像探讨大脑凸面小型脑膜瘤瘤周水肿与脑膜瘤病理亚型之间的关系。方法收集郑州大学第一附属医院2008年5月至2011年12月经手术病理证实的脑膜瘤患者46例,其中男性11例,女性35例。46例脑膜瘤患者术前均行MRI平扫及增强检查。结果本组46例大脑凸面小型脑膜瘤磁共振表现多为T1WI等信号,T2WI等信号,增强T1WI多为明显均匀强化。本组脑膜瘤瘤周水肿的发生率为50%。但是不同病理亚型脑膜瘤瘤周水肿程度不同。其中瘤周水肿的最大径值自高而低排序的脑膜瘤病理亚型分别是:血管瘤型、微囊型、纤维型、上皮型、混合型和砂粒体型。横纹肌型、脊索型及乳头型脑膜瘤未见瘤周水肿。结论磁共振成像能准确显示脑膜瘤瘤周水肿,不同病理亚型脑膜瘤瘤周水肿发生机制不同。

Objective To investigate the correlation between the MR image of peritumoral edema and pathological subtype of convex surface and small meningioma. Methods Clinical data of 46 patients with his- tologicallyproven convex surface small meningioma （ 11 males and 35 females） who received surgery in our hos- pital during May 2008 to December 2011 were enrolled in this study. Their preoperative MR images were col- lected and retrospectively analyzed with their clinical data. Results In our series of 46 cases of meningiomas, most MR findings are isointensity on T1WI and TEWI, and the enhanced T1 WI are obvious and homogeneous enhancement. There were 23 cases （50%） showing peritumoral edema. But there was no correlation of degree of peritumoral edema with different patholoical subtypes. The patholoical subtypes with larger diameter of peritu- moral edema was as following in a descending order： angiomatous, microcystic, fibrous, meningothelial, mixed, and psammomatous. But no edema was found in rhabdoid, chordoid and papillary meningiomas. Conclusion MR imaging could show the peritumoral edema. Various pathological subtypes of meningiomas have different mechanisms of peritumoral edema.