前颅凹底脑膜瘤的影像诊断与病理对照研究

The Anterior Skull Base Meningioma: Comparative Study of Pathological Features with Imaging Findings

目的 :探讨前颅凹底脑膜瘤的影像学和病理组织学之间的关系。材料和方法 :病理证实的前颅凹底脑膜瘤 2 7例 ,男 8例 ,女 19例。年龄 13～ 79岁 ,平均 62岁。均行MRI检查 (增强 16例 ) ;15例行CT检查 (增强 8例 )。分析CT、MRI影像 ,并与手术病理对照。结果 :2 7例前颅凹底脑膜瘤 ,起源于嗅沟 15例 ,前颅凹底 6例 ,眶顶 4例 ,鞍结节向前生长 2例。多数水肿明显 ,均匀增强 ;少数不均匀增强 ,并出现脑膜尾征 ,少数伴钙化、坏死、囊变和出血。累及邻近颅骨时引起骨质增生。结论 :前颅凹底脑膜瘤具有典型的影像学表现。CT和MRI具有诊断价值 ,MRI优于CT ,但CT观察钙化和骨质改变优于MRI。

Purpose:To study the pathological features of the anterior skull base meningioma and the imaging features on CT and MRI. Materials and Methods: Twenty seven patients with pathologically proved anterior skull base meningioma were examined by CT or MRI. 8 men and 19 women, ranging in age from 13-79 years old with average age 62. All patients were examined by MRI (sixteen with enhanced scan), fifteen patients by CT (eight with enhanced scan) and compared the image features with pathological findings. Results: Fifteen derived from olfactory groove, six from anterior skull base, four from orbital roof, and two from tuberculum sellae. The anterior skull base meningioma always were large, marked edema and homogeneous enhancement could be seen. Some had inhomogeneous enhancement, and dural tail sign. A few had cyst, calcification, necrosis or hemorrhage. The bones of the anterior skull base were involved in most cases. Conclusion: The anterior skull base meningioma has typical finding in imaging. CT and MRI are valuable examinations in diagnosis, MRI is much better than CT, but CT is superior to MRI in finding calcification in tumor and bone involvement of tumor.