脑膜瘤影像病例分析.pptVIP

Female, 53Y History : chief complaint :unconsciousness for half an hour, then headache and dizziness after accident when travel by bus nausea Past history : dizziness ability of memory, reaction, understanding and language lower than before for half a year Final diagnosis transitional meningioma Record of operation tension of brain tissue not high location: base of right temporal gray plenty blood supply adhesions between tumor with brain tissue and cerebral dura mater in the right temporal lobe meningioma WHO I low hyperplasia potentiality and healing by surgical ablation WHO II low hyperplasia potentiality but infiltrative growth, easy to recur WHO III nuclear atypia and active karyokinesis in part of area in histology Meningioma WHO Ⅰ Meningothelial Fibrous(fibroblastic) Transitional(mixed) Psammomatous Angiomatous Microcystic Secretory Iymphoplasma cyte—rich Metaplastic Ⅱ Ehordoid clear cell Atypical Ⅲ Papillary Rhabdoid anaplastie／malignant meningioma Simposon classification 1 肿瘤全切除，包括肿瘤黏着硬脑膜及受侵的静脉窦壁 9% 2 肿瘤全切除，肿瘤黏着硬脑膜电灼未切除 16% 3 肿瘤全切除，肿瘤黏着硬脑膜电灼未切除，肿瘤硬脑膜外侵犯硬脑膜窦，侵犯部分未切除 29% 4 肿瘤部分切除 39% 5 开颅减压 肿瘤活检或未活检 DDX typical meningioma atypical meningioma oligodendroglioma (anaplastic oligodendroglioma) typical meningioma CT scan iso or high density nodular or mass uniform density, local calcification wide basement skull change：thickening ，thinning，damage MRI scan iso or slightly long T1 signal, iso or slightly long T2 signal, high signal in DWI low signal in ADC uniform signal dural tail sign MRS NAA lack, Cho ,Cr , Ala appear common pathology type: transitional or desmocyte meningioma no or slight peritumoral brain edema atypical meningioma nonuniform density or signal cystic change, nodular at wall, calcification nonuniform enhanced, ring-shaped enhanced apparent peritumoral brain edema multiple common pathology type: syncytium or angioreticuloma meningioma oligodendroglioma 脑内肿瘤发生于皮层或皮层下的胶质母细胞瘤及胶质肉瘤多发生于脑表浅部位可累及脑膜但其囊变坏死明显多呈厚壁环形强化可见强化不