不典型脑膜瘤MRI表现及误诊分析

Misdiagnosis of atypical meningioma MRI manifestation analysis

目的探讨颅内不典型脑膜瘤的MRI表现特点并与组织病理对照,分析误诊原因,以提高脑膜瘤的MRI诊断准确率。材料与方法回顾性分析经手术病理证实的脑膜瘤22例,术前第一诊断均误诊为其他肿瘤,所有病例术前均行MRI平扫及增强扫描,将MRI表现与病理分级分型对照。结果 22例误诊病例MR征象:酷似脑内肿瘤的脑膜瘤8例,少见发病部位的脑膜瘤8例,常见部位的脑膜瘤6例;信号不均匀15例,形态不规则、具有侵袭性改变12例。术后病理特点:WHOⅠ级12例,WHOⅡ级4例,WHOⅢ级6例。结论因肿瘤组织学结构复杂、生物学特性差异及少见特殊发病部位,导致了脑膜瘤的不典型MRI表现,充分认识不典型脑膜瘤的MRI表现及其与病理分级分型的相关性,对提高诊断准确率具有重要价值。

Objective： To study the relationship between the atypical meningioma of MRI findings and its pathological features, analyze the reasons of misdiagnosis, to improve the diagnostic level. Materials and Methods：MRI findings of 22 cases meningioma confirmed by surgery and pathology were analyzed retrospectively. All cases were performed enhanced MRI. Results：MRI ifndings of all the 22 cases meningioma were as following： 8 cases were exactly like intracerebral tumors, 8 cases located at uncommon sites, and 6 cases located at conman sites. Fifteen cases showed heterogeneous signal on MRI, 12 cases had invasive boundary. Pathological grade：WHO Ⅰ grade 12 cases, WHO Ⅱ grade 4 cases, WHO Ⅲ grade 6 cases. Conclusions：The reasons for misdiagnosis of meningioma on MRI include complexity of pathological changes, biological characteristics and unexpected locations. A key point of prompting the diagnosis of meningioma is to recognize the atypical ifndings on MRI combined with the pathological features.