脑膜瘤的MRI诊断价值(附60例分析)  

The diagnosis of magnetic resonance imaging of meningoma(A report of 60 cases)

作　　者：王胜军[1] 汪静[1] 曾瑾[1] 王喜青[1] 王云雅[1] 梁晓燕[1] 

机构地区：[1]第四军医大学西京医院核医学科,陕西西安710032

出　　处：《现代肿瘤医学》2008年第9期1482-1486,共5页Journal of Modern Oncology

摘　　要：目的:研究脑膜瘤的MRI影像特征,提高脑膜瘤的正确诊断率。方法:回顾分析2006.7-2007.6经病理确诊的脑膜瘤患者60例,男22例,女38例,最小年龄6岁,最大81岁,平均年龄34岁。全部病例均行MRIT1、T2加权及增强扫描。分别就脑膜瘤发生部位、病变大小、病变形态、信号特点、肿瘤常见征象、增强特点、脑外定位判断等方面进行总结。结果:以大脑凸面最多,27例,约占45%;其次为鞍区11例(18.3%),桥小脑角区8例(13.3%),小脑幕6例(10%),蝶骨嵴5例(8.3%),其余4例(6.7%)。病变直径:在(0.8-8.6)cm之间,平均3.8cm。病变形态:圆形和类圆形占82%,分叶及不规则占18%。信号特点:T1加权信号以等和略低信号为主,占66.7%,低信号26.7%,略高和高信号6.7%。T2加权信号以等信号和略高信号最多,约占70%,高信号26%,混杂信号4%。肿瘤征象:脑膜尾征出现率为51.7%,假包膜出现率为48.3%,脑实质挤压征出现率达38.3%。瘤周水肿出现率达43.3%。其它少见的征象包括囊变、出血、钙化和瘤内血管征等。增强特点:明显均匀性增强占86.7%,明显不均匀性增强占13.3%。脑外定位判定:本组35%的脑膜瘤脑脊液-血管周围间隙明显较对侧增大。50%的脑膜瘤以广基与硬脑膜相连,肿瘤与硬脑膜相连处常为钝角。1/3多的肿瘤表现为脑实质挤压征。少数肿瘤可以出现静脉窦阻塞和脑外动脉包绕。这些征象可以作为脑外肿瘤的定位判断。结论:全面分析肿瘤发生部位、病变形态、信号特点、肿瘤常见征象、增强特点、脑外定位判断,可以提高脑膜瘤的正确诊断率,尤其是脑实质外肿瘤的判定、T1WI及T2WI的典型信号、脑膜尾征、假包膜和明显均匀强化是诊断脑膜瘤的关键。Objective ：To study the character of magnetic resonance imaging （MRI）of meningoma,in order to improve the correct rate. Methods： Retrospective analysis of 60 patients who confirmed by pathology in our hospital from June 2006 to July 2007. Male 22 , female 38, age from 6 to 81years old , average was 34. All the cases were scanned with T1, T2 weight imaging （T1 WI, T2 WI） and contrast - enhancementT1 WI. To summarize the character of MRI including location, size, character of signal, signs of tumor, information of contrast - enhancement and how to discriminate the tumor was an extra-brain tumor. Results： Location： among the 60 cases, 45% tumors located in convexity of brain, and following were in saddle area, cerebellopontine angle, tentorium of cerebellum and crista sphenoidalis, the rate of them were 18.3% ,13.3%, 10%, 8.3%, respectively. The others were 6.7%. Size： from 0.8cm to 8.6cm , average was 3.8cm. Figure of tumor： round and similar round were 82%, sublobe and irregular were 18%. Character of signal：equation and slight low signal were dominate, about 66.7% , low signal was 26.7% , slight high and high signal were 6.7% on T1WI. Equation and slight high signal were 70%, high signal was 25% , and mix signal was 5% on T2WI. Signs of tumor： the rate of tail sign was 51.7% , pseudo - capsule was 48.3%, edema of tumor occurred in 43.3% cases. Other rare signs included cystic, bleeding, calcification, and vessel symptom of tumor. Information of contrastenhancement： obvious and even enhancement was 86.7%, obvious but uneven was 13.3 %. Evidence of extra - brain tumor, among the 60 cases, cerebrospinal fluid and perivascular space was wider than opposite side in 35% tumors. Tumors that connected to cerebral dura mater with a wide fundament were in 50% cases. Extruding sign brain parenchyma was found in more than 38% cases. Blockage of sinus venous and circumvolution of out - brain artery were found in some tumors. All of the signs can be used to judge the tumor was an extra - brain tumor.

关 键 词：脑膜瘤 MRI 诊断 

分 类 号：R739.45[医药卫生—肿瘤]