良性脑膜瘤MRI特征及病理类型与肿瘤复发的相关性分析  

MRI features and pathologic types of benign meningiomas and their correlation with tumor recurrence

作　　者：杜铁桥[1] 朱明旺[1] 赵殿江[1] 齐雪岭[1] 王丽宁[1] 张旭妃[1] 

机构地区：[1]北京三博脑科医院放射科首都医科大学第十一临床医学院,100093

出　　处：《中华放射学杂志》2014年第3期197-201,共5页Chinese Journal of Radiology

摘　　要：目的 分析良性脑膜瘤的MRI表现、病理类型、病程等因素与肿瘤复发之间的关系.方法 良性脑膜瘤患者218例,男58例,女160例,年龄4～ 79岁.其中31例为复发性脑膜瘤（复发组）,187例为原发性脑膜瘤（原发组）.所有患者均经术后病理证实.采用x2检验和秩和检验比较原发组与复发组脑膜瘤不同病理类型、MRI表现等的差异.以肿瘤是否复发为因变量,以年龄、性别、累及重要结构、病理类型等指标作为自变量,进行多元Logistic回归分析.并对累及不同重要结构的肿瘤复发时间间隔进行秩和检验.结果 复发组中,30例有颅内重要结构受累或颅内外沟通瘤,比例显著高于原发组（61例）,差异有统计学意义（x2 =57.672,P=0.001）.复发组肿瘤位于颅底和窦旁者（30例）比例显著多于原发组（127例）,差异有统计学意义（x2=10.990,P=0.001）.多元Logistic回归分析显示：只有累及颅内重要结构或颅内外沟通瘤的复发风险显著升高（wald x2=31.862,优势比=3.820,P =0.001）,其中硬膜窦受累的复发风险是脑动脉及颅神经受累等的3.820倍,后者又是未受累者的3.820倍.脑膜瘤病理类型、所在部位、瘤周水肿程度、肿瘤形态、体积大小在2组间差异无统计学意义.复发组累及硬膜窦和脑动脉主干的复发时间的中位数和范围分别为24（13 ～ 180）个月和126（12 ～ 187）个月,2种结构受累的复发时间差异有统计学意义（Z=2.197,P=0.028）.结论 位于颅底和窦旁的脑膜瘤复发更多见.颅内重要结构受累或沟通瘤显著增加良性脑膜瘤的复发风险.良性脑膜瘤累及硬膜窦的复发时间可能比累及脑动脉主干的复发更快.MRI在预测良性脑膜瘤的复发和预后中能发挥作用.Objective To determine MR manifestations and pathologic types of benign meningiomas and their relationship with tumor recurrence.Methods There were 218 patients （160 females,58 males; age range 4-79 years） with benign meningiomas in the study,including 31 recurrent meningiomas （recurrence group）and 187 primary meningiomas （primary group）.All patients were proved by postoperative pathology.Differences of pathological types and MRI manifestations between the recurrence group and the primary group were evaluated by using x2 test and rank sum test.Logistic regression analysis was performed by taking tumor recurrence as the dependent variable,and age,gender,vital structures involvement and pathologic types as independent variables.The recurrent time intervals were compared by rank sum test.Results There were 30 patients with intracranial vital structures involvement or extreintracranial communication tumors in the recurrent group,which was obviously higher than that of the primary group （61 patients）.The difference was statistically significant （x2 =57.672,P =0.001）.The tumors located in the skull-base and juxtasinus in the recurrent group were obviously more than those in the primary group,and difference was statistically significant （x2 =10.990,P =0.001）.Multi-logistic regression analysis showed that the recurrent risk of benign meningiomas was elevated significantly only with vital structure involvement or extre-intracranial communication tumors （wald x2 =31.863,OR =3.820,P =0.001）.The recurrent risk of dural sinus involvement was 3.820 times of cerebral artery trunk and cranial nerves involvement,and the risk of the latter was 3.820 times of the non-involved.There was no statistical difference between the two groups in pathology type,location,peritumoral edema,tumor morphology and tumor size.The relapse time of dural sinus involvement and cerebral artery trunk involvement in the recurrent group was 24（13 to 180） and 126（12 to 187） months,respectively.There was significant differ

关 键 词：脑膜瘤 复发 病理学 磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤]