恶性脑膜瘤42例MRI影像特征分析

MRI features of malignant meningioma in 42 patients

目的探讨恶性脑膜瘤的MRI影像特征。方法回顾性分析42例经手术组织病理证实为恶性脑膜瘤患者的MRI资料,观察其MRI影像特征。结果 42例恶性脑膜瘤中,22例位于大脑凸面,15例位于上矢状窦旁,4例位于鞍区,1例位于右侧脑室三角区;19例肿瘤呈分叶状,13例呈结节状,8例呈不规则形,2例形态规整;其中18例边界模糊,14例边界部分模糊;35例T1WI以不规则混杂等、低信号多见,33例T2WI以高、等混杂信号多见,28例有明显瘤周水肿;增强扫描36例肿瘤呈明显非均匀性强化,26例肿瘤显示粗短的脑膜尾征。结论恶性脑膜瘤好发于大脑凸面或上矢状窦旁,MRI增强扫描明显强化;肿瘤形态不规则,呈分叶状、结节状,边界模糊、信号不均匀,脑膜尾征粗短、不光滑是其特征性MRI影像特征。

Objective To investigate the MRI features of malignant meningioma.Methods The MRI data of 42 patients with histopathologically confirmed malignant meningioma were retrospectively analyzed to observe the MRI performance.Results In 42 patients,the malignant meningioma was located at cerebral convexity in 22 patients,at parasagittal sinus in15,at tuberculum sellae in 4 and in the trigone of the right ventricle in 1.And the meningioma showed lobulated in 19 cases,nodular in 13,irregular in 8 and regular in 2.The tumor appeared unclear defined bordline in 18 patients and partial unclear defined bordline in 14.Thirty-five cases revealed irregular mixed isointense and low signals on T1 WI,and33 cases revealed mixed isointense and high signals on T1 WI.Peritumoral edema was found in 28 lesions.On gadolinium-enhanced T1 WI,heterogeneous enhancement was seen in 36 lesions,and stubby dural tail sign was seen in 26 lesions.Conclusion Malignant meningioma is mainly located at cerebral convexity and tuberculum sellae,with marked enhancement on MRI.The irregular morphology,lobulated and nodular shape,obscure border,signal inhomogeneity,and stubby dural tail sign are the MRI characteristic performance of malignant meningioma.