钙化性脑膜瘤磁共振T_1加权像高信号分析

Analysis of calcified meningioma manifesting MR T_1WI hyperintensity

目的探讨以磁共振(MR),T_1加权像(T_1WI)高信号为主要影像表现的钙化性脑膜瘤的病理特点及信号产生机制,提高对该病的认识及诊断水平。方法收集经CT、磁共振成像(MRI)检查、手术病理证实的钙化性脑膜瘤58例,并对其中16例在MR T_1WI上以高信号为主要表现的病例进行回顾性分析,将MRI影像特征与CT及病理结果进行对照分析。结果 16例MR T_1WI高信号表现的钙化性脑膜瘤中纤维型1例,过渡型5例,砂砾体型10例,其中2例MRI误诊为亚急性期脑出血,1例被误认为含有顺磁性物质沉积的肉芽肿性病变,另13例诊断正确,后经CT检查证实均为钙化性病变,CT值280~770 Hu。结论钙化性脑膜瘤MR T_1WI高信号产生主要与砂砾体钙化进程、钙化的化学成分、晶粒大小有关,与脑膜瘤病理类型无显著相关性,结合病变的形态特征和CT征象,可以做出正确的诊断与鉴别诊断。

Objective To investigate the pathological changes and producing mechanism of calcified menin- gioma manifesting MR T1WI hyperintensity,and to improve the accuracy of diagnosis of the disease.Materials and Methods Collected 58 cases of calcified meningioma confirmed by CT, MRI and pathology,retrospective analysis 16 cases calcified meningioma manifesting MR T1WI hyperintensity proven by operative pathology, compared with patho- logical features and CT findings. Results One case was fiber,5 cases were transitional, 10 cases were psammomatous in the 16 cases calcified meningioma,all of the cases were showed as MR T1WI hyperintensity, Among them, 1 case were misdiagnosed as subacute hemorrhage in intracerebral stage by MRI, 1 case were mistaken for granuloma lesions paramagnetic material deposition, the other 1 cases were diagnosed correctly, all the lesions were confirmed as calci- fied lesions by CT examination,and CT value was 280-770 Hu. Conclusion MR T1WI hyperintensity of calcified meningioma generation mechanisms were associated with calcified psammoma bodies, chemical constituents of calcifi- cation, grain size, there were no significant correlation with pathological type. The correct diagnosis and differential diagnosis can be made by combining the morphological features and CT features of the lesions.