MRI影像学特征在鉴别诊断血管瘤型脑膜瘤中的应用

Application of preoperative MRI features in differential diagnosis of angiomatous meningioma

目的总结分析血管瘤型脑膜瘤（AM）患者磁共振成像（MRI）的表现特征，以期提高其诊断水平。方法回归性分析90例AM患者的临床资料，并与同期90例其他亚型脑膜瘤的影像学资料进行对比。结果90例AM患者中，幕上肿瘤66例，幕下肿瘤24例；84例边界清晰可见，6例边界较为模糊；肿瘤最大径（3.65±1.13）cm；大多数为类圆形，9例能够显现分叶；MRI平扫显示T1WI以等、低信号多见，T2WI以高信号为主；增强扫描示多数呈显著均匀强化。相比于其他亚型脑膜瘤，AM肿瘤最大径明显增大，钙化率明显降低，水肿率及血管流空信号率明显增高，水肿指数明显增大，差异均有统计学意义（P均〈0.05）。结论AM具备一些MRI特征，将其运用于AM鉴别诊断中，可提高AM诊断水平，但其确诊仍依赖于病理检查。

Objective To summarize and analyze the magnetic resonance imaging （MRI） features of angiomatous meningioma （AM） so as to improve the diagnostic level.Methods The clinical data of 90 patients with AM were analyzed retrospectively, and were compared with imaging data of 90 patients with other subtypes of AM.Results In 90 patients with AM, there were 66 cases of supratentorial tumor and 24 cases of subtentorial tumor. The boundaries were clear in 84 cases and obscure in 6 cases. The maximum diameter of the tumors was （3.65±1.13） cm. Most of them were round, and 9 cases showed lobulation sign. MRI scan mainly showed equal and low signals of T1WI and high signals of T2WI. The enhanced scan showed significant homogeneous enhancement. Compared with other subtypes of AM, the maximum diameter of AM was significantly longer, the calcification rate was significantly lower, while edema rate, vascular flow void rate and edema index were significantly higher （P〈0.05）.Conclusions AM has some characteristics in MRI, which can be used in the differential diagnosis of AM to improve the diagnostic level. However, the confirmed diagnosis still depends on pathological examination.