WHOⅠ级脑膜瘤各亚型MRI表现与病理对照研究

A correlative study between MRI features and pathology in subtypes of WHO grade Ⅰ meningiomas

目的：分析WHOⅠ级脑膜瘤各亚型MRI表现与病理学的关系,提高对脑膜瘤各亚型的诊断水平。材料和方法：收集手术并经病理证实的WHOⅠ级脑膜瘤131例,术前均行颅脑MR扫描,并对MRI表现进行分析,内容包括：T1WI信号强度、T2WI信号强度、瘤周水肿程度和肿瘤强化程度,分别给予量化,对照病理,行多样本秩和检验,P〈0.05有统计学意义。结果 ：WHOⅠ级脑膜瘤各亚型T1WI信号强度有统计学差异（χ^2=30.4,P〈0.001）,各亚型T_2WI信号强度有统计学差异（χ^2=20.1,P〈0.001）,各亚型瘤周水肿程度无统计学差异（χ^2=9.09,P=0.059）,各亚型强化程度有统计学差异（χ^2=47.2,P〈0.001）。结论 ：血管瘤型脑膜瘤易与其他亚型脑膜瘤鉴别;上皮型脑膜瘤次之;混合型脑膜瘤、纤维型脑膜瘤及砂粒体型脑膜瘤三者之间不易鉴别,但与血管瘤型脑膜瘤和上皮型脑膜瘤可鉴别。

Objective： To review the relationship between MRI features and pathology in subtypes of WHO grade Ⅰmeningiomas, and to improve the skill in diagnosis. Methods： MRI features and pathology of 131 surgically treated WHO grade Ⅰ meningiomas were retrospectively reviewed. The MRI features of meningioma were analyzed, including signal intensity on T_1-weighted and T_2-weighted images, peritumoral brain edema, and degree of enhancement in contrast-enhanced MRI.These features were scored according to their criteria. The correlation between MR features and pathology was calculated by Kruskal-Wallis H test（P0.05）. Results： T_1WI signal intensity in subtypes was statistically different（χ^2=30.4, P0.001）, and T_2WI signal intensity in subtypes was statistically different（χ^2=20.1, P〈0.001）. Peritumoral brain edema in subtypes was not statistically different（χ^2=9.09, P=0.059）. Enhancement degree in subtypes was statistically different（χ^2=47.2, P0.001）. Conclusion： The angiomatous meningioma is the easiest to be identified from other subtypes. The meningothelial meningioma is easier to be identified from other subtypes. Transitional, fibrous and psammomatous meningioma are hard to be identified from each other, but easier to be identified from angiomatous meningioma and meningothelial meningioma.