MRI综合评分评估脑膜肿瘤恶性程度的价值  

The value of MRI comprehensive scoring in evaluation of meningeal neoplasms malignant degree

作　　者：罗永军[1] 周俊林[1] 董驰[2] 刘建莉[1] 赵建洪[1] 牛茜[2] 李文一[1] 

机构地区：[1]兰州大学第二医院放射科,甘肃兰州730030 [2]兰州大学第二医院病理科,甘肃兰州730030

出　　处：《医学影像学杂志》2015年第1期18-22,共5页Journal of Medical Imaging

基　　金：甘肃省卫生行业科研计划项目(GSWST2012-01)

摘　　要：目的 探讨MRI综合评分在脑膜肿瘤术前WHO分级中的指导价值.方法 回顾分析经手术病理证实的脑膜原发肿瘤196例,将其MRI表现分为1 3个指标进行统计学分析并评分.结果 脑膜肿瘤的分叶征、信号均匀性、囊变坏死、出血、增强的均匀性、瘤周水肿、脑膜尾征及形态、瘤脑界面、瘤脑界面边缘及颅骨改变等征象在WHOⅠ～Ⅳ级之间有差异,并与病理分级相关（P＜0.05）,其中瘤周水肿、瘤脑界面及边缘、颅骨改变、坏死及脑膜尾的形态等为判断肿瘤恶性程度的主要影响因素,但各征象在不同分级之间有重叠;综合评分WHOI级脑膜肿瘤88％小于等于4分、WHOⅡ级84％在4～8分之间、WHOⅢ级90.7％在8～12分之间、WHOⅣ级75％大于12分.结论 MRI综合评分在脑膜肿瘤术前WHO分级评估中有参考价值.Objective To study the guidance value of MRI comprehensive scoring in meningeal neoplasm preoperative WHO grading. Methods 196 cases with primary meningeal neoplasms confirmed by surgery and pathology were studied retrospectively. MR manifestations were divided into 13 indicators, then scoring and statistical analysis were performed. Results I.obular sign, signal homogeneity, necrosis and cystic degeneration, hemorrhage, enhancement homogeneity, peritumoral edema, dural tail sign and morphology, brain-tumor interface, edge of brain- tumor interface and skull changes in meningeal neoplasms had differences between the WHO Ⅰ - Ⅳ grading, associated with pathologic grading （ P〈 0.05）, the main influencing factors of the tumor malignant degree were peritumoral edema, brain-tumor interface and edge, skull changes in meningeal neoplasms, necrosis and dural tail sign, but each imaging sign overlap existsed between different gradings, the comprehensive scoring in 88% WHO I meningeal neoplasms was less than or equal to 4 points, 84% WHO II meningeal neoplasms was between 4-8 points, 90.7% WHO III meningeal neoplasms was between 8 to 12 points, 75% WHO IV meningeal neoplasms was greater than 12 points. Conclusion MRI comprehensive scoring in preoperative WHO grading evaluation of meningeal neoplasms has reference value.

关 键 词：脑膜肿瘤 WHO分级 磁共振成像 综合评分 

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