磁共振黑血技术在矢旁脑膜瘤术前分型的应用

Preoperative Detection of Parasagittal Meningiomas Classification with 3D Gadolinium-Enhanced CUBE T1 Sequence

目的探讨磁共振黑血技术在矢旁脑膜瘤术前分型中的应用。方法对56例矢旁脑膜瘤患者术前行增强三维CUBE T1检查,所有患者均行脑膜瘤全切、伴或不伴矢状窦重建。两位放射科医生术前分别根据黑血序列对脑膜瘤进行分型,包括CUBEⅠ型(脑膜瘤紧贴上矢状窦外侧壁)、CUBEⅡ型(脑膜瘤侵犯矢状窦一侧壁)、CUBEⅢ型(脑膜瘤侵犯上矢状窦顶壁)、CUBEⅣ型(矢状窦闭塞、伴或不伴对侧壁侵犯),并与手术结果相对照。结果增强后CUBE T1序列可以为矢旁脑膜瘤术前分型提供可靠依据。观察者间一致性好(κ=0.831,95%置信区间0.706-0.955),讨论后的结果与手术结果一致性好(κ=0.755,95%置信区间0.602-0.908)。结论增强后CUBE T1序列可为矢旁脑膜瘤分型提供可靠信息。

Objective To evaluated the role of 3D gadolinium-enhanced CUBE T1in preoperative classification of parasagittal meningiomas.Methods 56 patients with parasagittal meningiomas were imaged with 3D gadolinium-enhanced CUBE T1sequence before they received surgery of a total removal of meningiomas with/without superior sagittal sinus(SSS)reconstruction.Two neuroradiologists independently assessed the images to decide the invasion degree including attachment to the outer surface of the SSS wall(CUBEⅠ),one-wall invasion of SSS(CUBEⅡ),two-wall invasion of the SSS(CUBEⅢ)and total occlusion of SSS(CUBEⅣ);Disagreements were resolved by discussion.All patients were operated on,and intraoperative findings were taken as the criterion standard.Results The use of 3D gadolinium-enhanced CUBE T1imaging was found to provide an easy way to detect the SSS invasion degree by parasagittal meningiomas.The inter-observer agreement was very good(κ=0.831,95%confidence interval 0.706–0.955)and the result after discussion was highly consistent with the surgical findings(κ=0.755,95%confidence interval 0.602–0.908).Conclusion In preoperative planning for patients with parasagittal meningiomas,3D gadolinium-enhanced CUBE T1sequence could provide reliable information for parasagittal meningioma classification.