恶性脑膜瘤的MRI表现  

MRI Features of Malignant Meningioma

作　　者：林艳飞[1] 余晶晶[1] 史玉振[1] 吴越菲[1] 张新华[1] 王中秋[1] 

机构地区：[1]徐州医学院,江苏徐州221004

出　　处：《临床放射学杂志》2013年第7期930-933,共4页Journal of Clinical Radiology

摘　　要：目的探讨恶性脑膜瘤的MRI特征表现。方法搜集经手术后病理证实的50例恶性脑膜瘤患者的MRI资料,观察肿瘤的生长部位、形态、瘤体平扫及强化信号特点、坏死囊变、肿瘤边界、瘤周水肿及邻近脑膜改变等特点并与病理对照分析。结果 50例中,肿瘤部位以大脑凸面及矢状窦旁多见,分别为15例(30%)及14例(28%)。肿瘤形态规则16例(32%),形态不规则34例(68%)。边界清晰19例(38%),边界不清晰31例(62%)。MRI平扫与脑灰质比较T1WI多呈稍低或等信号,T2WI多呈等及稍高信号,增强后均匀强化13例(26%),不均匀强化37例(74%)。16例(32%)可见明显囊变或坏死。34例(68%)瘤周见不同程度水肿。34例(68%)可见"脑膜尾征"。9例(18%)可见邻近颅骨破坏。复发者15例(30%)。其中29例免疫组织化学示Ki-67指数平均8.48%(1%～35%)。结论肿瘤形态不规则,瘤脑界面不清晰,信号不均匀,坏死、囊变,增强扫描不均匀强化,邻近骨质破坏等可考虑恶性脑膜瘤。Objective To explore the MRI characteristics of malignant meningiomas Methods MRI data of 50 pa- tients with malignant meningiomas proved by pathological results were analyzed. The features including the location, shape, signal intensity, enhancement, necrosis,cystic degeneration, the border, peritumoral brain edema and the change of adja- cent dura were observed compared with the pathology. Results Of 50 patients, meningiomas were mainly located at the convexity of brain and sagittal sinus in 15 cases （ 30% ） and 14 cases （ 28% ） respectively. 16 cases （ 32% ） had regular shape ,34 eases（68% ）had irregular shape. The border was clear in 19 cases（38% ） ,ill defined in 31 cases （62%）. The tumors were slightly hypointense or isointense to gray matter on T1 weighted images, whereas they were isointense or hyper- intense on T2 weighted. On enhanced Tl weighted images, homogeneous enhancement were seen in 13 cases（26% ）, and heterogeneous enhancement were seen in 37 cases （74%）. 16 cases（ 32% ）had obvious necrosis and cystic degeneration. 34 cases（68% ） had peritumoral brain edema in different degree. 34 cases（68% ） showed dural tail sign. 9 cases（ 18% ） in- vaded adjacent skull. 15 cases （30%） had relapse. The average Ki 67 of 29 cases was 8.48% （ 1% - 35% ） by immuno- histochemistry. Conclusion Irregular morphology, the ill -defined border, heterogeneous signal, necrosis, cystic degen- eration, heterogeneous enhancement and adjacent bone destruction can suggest malignant meningioma.

关 键 词：脑膜瘤 恶性 磁共振成像 病理学 诊断 

分 类 号：R739.45[医药卫生—肿瘤]