几种少见病理类型脑膜瘤的MRI表现与病理相关性研究

Study on the correlation between MRI manifestations and pathology of several rare types of meningioma

目的分析几种少见病理类型脑膜瘤的MRI表现,探讨其MRI表现与病理相关性。方法回顾性分析病理证实的微囊型脑膜瘤、透明细胞型及血管瘤型脑膜瘤的临床及MRI资料,10例均行MRI平扫及增强。结果肿瘤发生于大脑半球凸面5例,前颅窝嗅沟1例,上矢状窦旁2例,大脑镰旁2例。8例肿瘤轮廓光整,边界清晰,与邻近颅骨呈宽基底改变。2例肿瘤轮廓不光整,边界不清。8例肿瘤周围见轻度水肿带,1例水肿较明显,1例无明显水肿。6例微囊型脑膜瘤MRI平扫呈长T1、长T2信号,增强后呈网格状强化,2例透明细胞型脑膜瘤MRI平扫表现为长T1、长T2信号,与脑脊液信号接近,增强后呈不均匀环状强化,2例血管瘤型脑膜瘤MRI平扫为稍长T1、长T2信号,肿瘤中可见流空的血管信号,增强后呈显著明显强化。结论微囊型、透明细胞型、血管瘤型脑膜瘤MRI表现与病理改变有明显相关性。

Objective To analyze the MRI manifestations of several rare types of meningioma and to discuss the correlation between MRI findings and pathology of these tumors. Methods Clinical and MRI data of ten cases of meningioma, including the microcystic type, transparent cell type and hemangioma type, which were confirmed by pathology, were ret- rospectively analyzed in this work. All of ten patients underwent plain and contrast-enhanced MRI scan. Results Of these 10 cases, 5 were originated from the cerebral hemisphere pits, 1 from the former cranial fossa olfactory groove case, 2 from the superior sagittal sinus side and 2 from the falx cerebri side. 8 cases were shown clear contour of tumor, with lim- ited boundary and the adjacent skull appeared wide base alteration. The other 2 cases were shown unclear contour of tumor, with unlimited boundary. 8 cases apeared mild edema zone around the tumors, 1 case presented with obvious ede- ma, and and 1 case without obvious edema. In 6 cases of microcapsule type of meningiomas, plain MRI exhibited a long T1 and long T2 signal and the mesh shape apperred after reinforcement. In 2 cases of transparent cell type of meningioma, plain MRI showed the long T1 and long Tz signal, which was similar to the cerebrospinal fluid signal, close, and the en- hanced MRI showed unevenly annular strengthening. In 2 cases of hemangioma type of meningioma, plain MRI showed a bit long T1 and long T2 and tumors presented with visible empty vessel signal, the enhanced MRI showed obviously enhancement. Conclusion MRI manifestations and pathological changes are significantly correlated among the microcapsule type, transparent cell type, hemangioma type of meningioma.