微囊型脑膜瘤与非典型性脑膜瘤影像学对比研究

Imaging of Microcystic Meningioma and Anaplastic Meningioma: A Comparative Study

目的对比分析微囊型脑膜瘤(WHO Ⅰ级)与非典型性脑膜瘤(WHO Ⅱ级)的影像征象,提高对两者的鉴别诊断水平。资料与方法收集经手术病理证实的13例微囊型脑膜瘤与28例非典型性脑膜瘤的临床及影像学资料,对两种病理亚型脑膜瘤的分叶状、肿瘤囊变、强化均匀性、瘤周水肿、瘤脑界面、脑膜尾征、邻近颅骨改变征象进行回顾性分析。结果 13例微囊型脑膜瘤与28例非典型性脑膜瘤相比,分叶状(χ2=6.034,P<0.05)、肿瘤囊变(χ2=9.784,P<0.01)、瘤周水肿程度(χ2=7.336,P<0.01)、瘤脑界面(χ2=11.490,P<0.01)、邻近骨质改变(χ2=10.134,P<0.01)5项影像学征象差异有统计学意义;强化均匀性、脑膜尾征差异无统计学意义(χ2=2.259、0.196,P>0.05)。结论微囊型脑膜瘤与非典型性脑膜瘤在肿瘤分叶状、肿瘤囊变、瘤周水肿程度、瘤脑界面、邻近骨质改变方面存在差异,能为两种病理亚型脑膜瘤的鉴别诊断提供参考。

Purpose To analyze imaging features of microcystic meningioma （WHO grade 1） and atypical meningioma （WHO grade 11） for a better differential diagnosis. Materials and Methods The clinical and imaging data of 13 cases of microcystic meningioma and 28 cases of atypical meningioma confirmed surgically and pathologically were retrospectively studied in terms of MRI features such as lobulated sign, necrosis and cystic change, peritumoral edema, brain tumor interface, adjacent bone change, dural tail sign and homogenous enhancement. Results Differences in lobulated sign （X2=6.034, P〈0,05）, necrosis and cystic change （X2=9.784, P〈0.01）, peritumoral edema （X2=7.336, P〈0.01）, brain tumor interface （X2=11.490, P〈0.01） and adjacent bone change （X2= 10.134, P〈0.01） between microcystic meningioma and atypical meningioma were statistically significant; differences in dural tail sign （X2=0.196,P〉0.05） and homogenous enhancement of the tumor （X2=2.259,P〉0.05） were not statistically significant. Conclusion The MRI features such as lobulated sign, necrosis and cystic change, peritumoral edema, brain tumor interface and adjacent bone change are helpful in differential diagnosis of microcystic meningioma and atypical meningioma.