蝶骨嵴脑膜瘤的MRI征象分析  

Analysis of MRI Features of Sphenoid Ridge Meningioma

作　　者：段小慧[1] 班晓华[1] 成丽娜[1] 钟小梅[1] 沈君[1] 梁碧玲[1] 叶瑞心[1] 钟镜联[1] 

机构地区：[1]中山大学第二附属医院放射科,广州510120

出　　处：《临床放射学杂志》2009年第4期451-455,共5页Journal of Clinical Radiology

摘　　要：目的分析蝶骨嵴脑膜瘤的MRI特点及其对手术治疗的指导价值。资料与方法搜集经手术病理证实的19例蝶骨嵴脑膜瘤患者的MRI表现,回顾性分析其平扫及增强后的形态学特征及周围结构的改变。结果19例共19个脑膜瘤,信号均匀10例,T1WI上呈低信号10例,T2WI上呈稍高信号6例,高信号7例;10例显著均匀强化,14例出现"脑膜尾征",13例出现瘤周水肿。19例中内侧型11例,外侧型6例,扁平型2例,肿瘤全切除分别为2、6、1例,最大直径<3cm者3例,3～5cm者11例,>5cm者5例。10例侵犯海绵窦,5例视交叉受压,10例颈内动脉部分或全部包绕,全切1例。Levine术前评分,6例0分,肿瘤均完整切除;8例1分,2例肿瘤全切;4例2分,1例肿瘤全切;1例3分,全切0例;无4分以上患者。共9例肿瘤完整切除。结论蝶骨嵴脑膜瘤的MRI表现具有一定的特征性,较易侵犯周围结构,术前详细评估肿瘤的特征有利于判断肿瘤完整切除的可能性。Objective To analyze the MR features of sphenoid ridge meningioma and evaluate its value for operation. Materials and Methods 19 patients of sphenoid ridge meningioma with surgically and pathologically proved were enrolled. The MR imaging features about the shape and periphery extended of lesions were retrospectively analyzed. Results In 19 patients, a total of 19 lesions were found. The lesions in 10 patients showed homogeneous signal intensity. Hypointensity signal in T1WI was observed in 10 patients. Slight hyperintensity signal in T2 WI was observed in 6 patients, and hyperintensity signal in 7 patients. Significant homogenously enhancement was observed in 10 patients. Tail sign occurred in lesions of 14 patients. Peritumoral edema occurred in 13 patients. The lesions of 11 were medial type, 6 lateral type and 2 En plaque type, and 2, 6, 1 patients received an en bloc resection of tumor respectively. The maximal diameter in 3 patients was under 3 era, in 11 patients 3 cm to 5 cm and in 5 patients over 5 cm. In 10 tumors extended into cavernous sinus, and chiasm opticum was involved in 5 patients and in 10 tumors enclosed partially or completely the cavernous segment of internal carotid artery with an en bloc resection of tumor in 1 patient In the Levine preoperative score, 6 patients with 0 score, all of them had an en bloc resection; 8 patients with 1 score, 2 of them had an en bloc resection; 4 patients with 2 score, 1 had an en bloc resection; 1 patients with 3 score, none had an en bloc resection. No patient had more than 4 score. Totally, 9 patients had an en bloc resection of tumor. Conclusion Sphenoid ridge meningiomas have some specific MR features, invasion of the surrounding tissues occur frequently, detailed evaluation of radiological features is useful for prediction of en bloc resection of the tumors.

关 键 词：脑膜瘤 蝶骨嵴 磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤] R744[医药卫生—临床医学]