血管瘤型脑膜瘤的常规 MRI、DWI 特征与病理基础  

Conventional MRI,DWI characteristics and pathological basis of angiomatous meningioma

作　　者：徐鹏[1] 徐凯[1] 吕璐璐[1] 

机构地区：[1]徐州医学院附属医院影像科,江苏徐州221006

出　　处：《实用放射学杂志》2014年第6期911-913,922,共4页Journal of Practical Radiology

摘　　要：目的：探讨血管瘤型脑膜瘤的常规 MRI、DWI 特征及其病理学基础。方法回顾性分析7例经手术病理证实的血管瘤型脑膜瘤的常规 MRI、DWI 表现及其病理特征,测量肿瘤及对侧正常脑实质 ADC 值,并进行对比分析。结果7例血管瘤型脑膜瘤中5例位于大脑凸面（额部4例,顶部1例）,2例位于鞍旁。常规 MRI 序列6例肿瘤呈长 T1长 T2信号,1例呈等 T1等 T2信号。5例肿瘤 FLAIR 序列可见明显瘤周水肿,2例可见肿瘤内部坏死,6例肿瘤内部可见流空血管影,所有肿瘤 T1 WI 增强序列均呈明显强化。7例肿瘤平均 ADC 值（1.35×10-3 mm2/s）大于对侧正常脑实质（0.92×10-3 mm2/s）（t=7.21,P 〈0.01）。病理切片7例肿瘤内均可见成熟血管成分,免疫组化肿瘤细胞6例波形蛋白染色（Vim）阳性,1例散在阳性,7例上皮膜抗原（EMA）均阳性。结论血管瘤型脑膜瘤 MRI 表现具有一定特征性,与肿瘤富有血管成分有关。病灶 ADC 值较健侧增高,有助于此肿瘤的诊断。Objective To explore the conventional MRI,diffusion-weighted imaging （DWI）characteristics and the pathological basis of angiomatous meningioma.Methods The conventional MRI,DWI and pathological manifestations of 7 cases with angioma-tous meningioma confirmed by surgery and pathology were analyzed retrospectively.The apparent diffusion coefficient （ADC）value of the tumors and contralateral normal brain parenchyma were measured and compared with each other.Results Among the 7 cases,5 cases were in the convexity of brain （4 cases in the frontal part and 1 case in the parietal part）,and 2 cases in the parasella. 6 cases showed hypointense on T1 WI and hyperintense on T2 WI,and 1 case showed isointense on both T1 WI and T2 WI.The necrosis within the tumor was seen in 2 cases.The flowing void phenomenon was seen in 6 cases.The significant peritumoral edema was seen in 5 cases on FLAIR.Significant enhancement on contrast-enhanced T1 WI was seen in all the cases.The average ADC value of the tumors （1.35×10 -3 mm2/s）was significently higher than that of the contralateral normal parenchyma （0.92 ×10 -3 mm2/s） （t=7.21,P 〈0.01）.Mature vessel component was seen on pathological section in all the cases.For immunohistochemically analysis,the expression of vimentin （Vim）was positive in 6 cases and scattered positive in 1 case.The expression of epithelial membrane antigen （EMA）was positive in all the cases.Conclusion The MRI features of angiomatous meningioma are closely correlated with rich blood vessels.The ADC value of the tumor is higher than that of the contralateral parenchyma,which is helpful for the diagnosis.

关 键 词：脑膜瘤 血管瘤型 磁共振成像 病理学 

分 类 号：R739.45[医药卫生—肿瘤] R445.2[医药卫生—临床医学]