分析多模态MRI成像在脑膜瘤诊断中的应用效果

Analysis on the Application Effect of Multimodal MRI Imaging in the Diagnosis of Meningioma

目的分析多模态MRI成像在脑膜瘤诊断中的应用效果。方法对该院神经外科于2018年10月—2020年3月收治的68例脑膜瘤患者进行研究,所有患者均经过病理学检测证实为脑膜瘤,均接受了磁共振平扫与增强扫描、扩散加权成像检查、核磁共振血管成像检查。回顾性分析68例患者磁共振检查结果与影像学表现。结果多模态磁共振检出符合率为97.06%(66/68),2例被误诊为脑胶质瘤。在66例检出患者中,34例病灶边界清晰、规则,为WHOⅠ级脑膜瘤;30例为WHOⅡ级脑膜瘤,2例为WHOⅢ级脑膜瘤。在66例检出患者中,34例为WHOⅠ级脑膜瘤,其中过渡型脑膜瘤13例,纤维型脑膜瘤13例,血管型脑膜瘤5例,砂粒型脑膜瘤3例;30例为WHOⅡ级脑膜瘤,其中砂粒型脑膜瘤16例,混合型脑膜瘤12例,透明细胞型脑膜瘤2例;2例为WHOⅢ级脑膜瘤,均为横纹肌样脑膜瘤。另有2例经过病理学诊断为WHOⅠ级脑膜瘤,均为纤维型脑膜瘤。68例脑膜瘤患者中,所有患者图像可见不同程度占位效应,其中53例病灶周围可见明显的水肿图像,MRI平扫与扩散加权成像检查增强扫描显示大部分患者为不均匀-中等明显强化,18例为均匀中等-明显强化,34例可见脑膜尾征,其余可见D字征。MRA检查病灶内或病灶边缘可见血管推移包绕,其中13例还可见多发血管穿行。结论多模态MRI成像对脑胶质瘤有较高的诊断符合率,对脑膜瘤定性诊断具有较高的参考价值,值得应用。

Objective To analyze the application effect of multimodal MRI imaging in the diagnosis of meningioma.Methods A study was conducted on 68 patients with meningiomas admitted to the Department of Neurosurgery of the hospital from October 2018 to March 2020.All patients were confirmed to be meningiomas through pathological examinations,and all received MRI plain scan and enhanced scan,diffusion weighted imaging examination,and MRI angiography examination.Retrospective analysis of 68 patients with magnetic resonance examination results and imaging manifestations.Results The coincidence rate of multimodal MRI was 97.06%(66/68),and 2 cases were misdiagnosed as glioma.Among the 66 detected patients,34 had clear and regular lesions and were WHOⅠmeningioma;30 were WHOⅡmeningioma,and 2 were WHOⅢmeningioma.Of the 66 detected patients,34 were WHO grade I meningioma,including 13 transitional meningioma,13 fibrous meningiomas,5 vascular meningioma,and 3 pomaceous meningioma;30 were WHO grade II Meningiomas included 16 cases of sand grain type meningioma,12 cases of mixed type meningioma,2 cases of clear cell type meningioma;2 cases were WHOⅢgrade meningioma,both of which were rhabdoid meningioma.Another 2 cases were pathologically diagnosed as WHO grade I meningioma,both of which were fibrous meningiomas.Among 68 patients with meningioma,all the patients’images showed different degrees of space-occupying effect.Among them,53 patients showed obvious edema images around the lesions.MRI scan and diffusion-weighted imaging enhanced scan showed that most of the patients had uneven-moderately significant enhancement.18 cases showed uniform medium-significant enhancement,34 cases showed meningeal tail sign,and the rest showed D sign.In the MRA examination,blood vessels were visible in the lesion or on the edge of the lesion,and multiple blood vessels were also seen in 13 cases.Conclusion Multimodal MRI imaging has a high diagnostic coincidence rate for glioma,and has a high reference value for the qualitative diagnosis of meningioma,and is worthy of application.