MRI对颅内孤立性纤维瘤/血管外皮瘤分级诊断的价值

The value of MRI in differential diagnosis of intracranial solitary fibroma and angioderma tumor

目的:探究核磁共振成像(MRI)在颅内孤立性纤维瘤/血管外皮瘤(SFT/HPC)Ⅰ、Ⅱ级诊断鉴别中的价值。方法:回顾性分析2016年3月至2019年3月经手术病理证实SFT/HPC的39例患者MRI影像资料,其中WHO-Ⅰ级24例、WHO-Ⅱ级15例,从病灶形态、T2WI信号及DWI特征分析其差异。结果:WHO-Ⅰ级(SFT)和WHO-Ⅱ级(HPC)患者的MRI影像在病灶形态、阴阳征、囊变/坏死等方面存在显著差异(P<0.05);而病灶/水肿最大径、水肿指数、术中出血量和Ki-67%指数差异无统计学意义(P>0.05);DWI扫描信号特征及表观扩散系数(ADC)值存在细微差异,组间差异无统计学意义(P>0.01)。结论:MRI影像表现中病灶形态、阴阳征、囊变/坏死可作为SFT/HPC病理分级鉴别的征象,而DWI征象在病理分级诊断中应用有待进一步验证。

Objective:To explore the value of magnetic resonance imaging(MRI)in the differential diagnosis of grade Ⅰ and Ⅱ of intracranial solitary fibroma/vascular epithelioma(SFT/HPC).Methods:A retrospective analysis of MRI images of 39 patients with SFT/HPC confirmed by surgery and pathology from March 2016 to March 2019,including 24 cases of WHO-Ⅰ grade and 15 cases of WHO-Ⅱ grade.From lesion morphology and T2WI signal and DWI features,the differences were analysed.Results:MRI images of patients with WHO-Ⅰ(SFT)and WHO-Ⅱ(HPC)were significantly different in lesion morphology,Yin and Yang,cystic/necrosis(P<0.05).There was no significant difference in maximum diameter of lesion/edema,edema index,intraoperative blood loss and Ki-67%index(P>0.05).There were slight differences in DWI scan signal characteristics and apparent diffusion coefficient(ADC)values,and there was no statistical significance between the groups(P>0.01).Conclusion:MRI findings in lesions,Yin and Yang signs,cystic changes/necrosis can be used as signs of SFT/HPC pathological classification,and the application of DWI signs in pathological grading diagnosis needs further verification.