少见类型脑膜瘤的影像学特点及误诊分析

Analysis of imaging characteristics and misdiagnosis for atypical meningioma

目的:对不典型脑膜瘤患者的临床及影像学特点进行分析,提高其术前诊断正确率。方法:回顾性分析21例经病理证实或术前误诊为脑膜瘤病例的影像及临床资料。结果:21例病变中,15例脑膜瘤术前被误诊为胶质瘤7例,室管膜瘤、血管外皮细胞瘤及听神经瘤各2例,PNET及颅骨肿瘤各1例;其中13例病灶呈单发且信号不均,12例呈不均匀轻度强化,8例可见脑膜尾征,2例多灶性脑膜瘤同时累及胼胝体。其他病变被误诊为脑膜瘤者6例,分别为脑血管畸形伴出血、朗格汉斯细胞增生症、海绵状血管瘤、颅咽管瘤、胶质母细胞瘤及血管周细胞瘤各1例。结论:在准确定位的前提下,加深对发生于少见部位及特殊病理类型脑膜瘤的认识,可有效减低术前误诊率。

Objective： To analyze the clinical and imaging characteristics of atypical meningioma,improve the accuracy of preoperative diagnosis. Methods： In order to analyze misdiagnosis causes and imaging traits of atypical meningioma,a retrospective analysis of 21 cases confirmed or misdiagnosed as meningioma has been made. Results： In 21 cases,15 cases misdiagnosed as meningiomas were confirmed as glioma for 7 cases,ependymoma,hemangiopericytoma and acoustic neuroma for 2 cases,PNET and skull tumor for 1 case respectively. 13 cases of them showed single lesion with uneven intensity,12 cases with uneven and slight enhancement,8 cases with dural tail sign. Some cases of cerebrovascular malformation,langerhans cell hyperplasia,cavernous hemangioma,craniopharyngioma,glioblastoma and hemangiopericytoma were misdiagnosed as meningioma preoperatively. Conclusion： On the premise of accurate positioning,deepening the understanding of meningiomas with rare location and special pathological types can effectively reduce the preoperative misdiagnosis rate.