良恶性脑膜瘤MRI对比分析_医学论文.docVIP

良恶性脑膜瘤MRI对比分析_医学论文 良恶性脑膜瘤MRI对比分析_医学论文 【摘要】 目的 探讨MRI对良恶性脑膜瘤的诊断价值。方法 回顾性分析了12例恶性脑膜瘤和20例良性脑膜瘤的MRI资料。恶性脑膜瘤12例中，行MRI平扫9例，增强扫描7例；良性脑膜瘤20例均行MRI平扫及增强扫描。结果 良恶性脑膜瘤在肿瘤形态、边缘、强化方式、脑脊液血管间隙和脑膜尾征形态方面差异均有显著性（P＝0.000～0.043）；而瘤周水肿、肿瘤的信号（T1WI、T2WI、FLAIR、DWI）方面差异则无统计学意义（P＝0.087～0.948）。结论 良恶性脑膜瘤的MRI表现存在部分重叠，但是分析肿瘤的形态、边缘、强化方式、脑膜尾征形态和脑脊液血管间隙的征象，可以提示恶性脑膜瘤的诊断。 【关键词】 脑膜瘤 磁共振成像 诊断 鉴别 ［ABSTRACT］ObjectiveTo assess the value of MRI in the diagnosis of benign and malignant meningiomas. MethodsMRI data of 12 cases of malignant meningioma and 20 benign cases were analyzed retrospectively. Of the malignant cases,nine underwent plain scan and seven enhancement scanning, for the benign ones, both plain and enhancement scanning were done.ResultsThe differences between benign and malignant meningioma were significant in terms of tumor shape, edge, features of enhancement, cerebrospinal fluidblood vessel gaps and the shape of meninges tail sign (P=0.000-0.043),but no significant differences were noted as to edema around the tumor and the characteristics of MRI signals (T1WI,T2WI,FLAIR,DWIP=0.087-0.948). ConclusionThough a partial overlapping exist between benign and malignant meningiomas on MRI manifestations, an analysis of their features mentioned above suggesting of the diagnosis of malignant meningeoma. ［KEY WORDS］meningeoma nuclear magnetic resonance diagnosis, differential 脑膜瘤是常见的颅内原发性肿瘤，约占所有颅内肿瘤的15％～20％，其中大约有5％～12％属于恶性［1，2］。良恶性脑膜瘤在影像学上常不易区别。本文收集我院2003～2005年经手术病理证实的12例恶性脑膜瘤的MRI资料，并与随机抽取的20例资料完整的良性脑膜瘤作回顾性对比分析，旨在提高良恶性脑膜瘤的MRI鉴别诊断水平。 1 资料与方法 1.1 一般资料 良性脑膜瘤病人（良性组）20例，男3例，女17例；年龄26～70岁，平均52.9岁；其中脑膜内皮型9例，纤维型5例，合体细胞型2例，混合型2例，血管瘤样型和血管母细胞型各1例。恶性脑膜瘤病人（恶性组）12例，男4例，女8例；年龄27～64岁，平均46.0岁；其中脑膜内皮型3例，纤维型4例，不易确定组织类型者5例。 1.2 检查方法 12例恶性脑膜瘤病人中，行MRI平扫9例，增强扫描7例。20例良性脑膜瘤病人均作了MRI平扫及增强扫描。检查设备为美国GE公司生产的SIGNA 1.5 T超导型MR机。MRI平扫方位及序列包括矢状位SE T1WI、横轴位SE T1WI、FSE T2WI、FLAIR、DWI；MRI增强扫描方位及序列包括横轴位、矢状位和冠状位T1WI。MR扫描参数T1WI：TR 400 ms,TE 10 ms；T2WI：TR 2 800 ms，TE 106 ms；FLAIR：TR 6 000 ms，TE 160 ms，TI 1 500 ms；DWI取b值=1 000。