恶性脑膜瘤的MRI影像表现分析  

MRI features of malignant meningioma

作　　者：马洪兵 高峰[2] 

机构地区：[1]南京扬子医院放射科,江苏南京210048 [2]南京医科大学附属南京儿童医院放射科,江苏南京210008

出　　处：《医学影像学杂志》2016年第3期385-388,共4页Journal of Medical Imaging

摘　　要：目的探讨恶性脑膜瘤的MRI征象,并结合文献,提高对该病的诊断及鉴别诊断水平。方法回顾分析18例经手术和病理证实的恶性脑膜瘤的MRI表现。结果 18例中,大脑凸面7例(7/18),矢状窦旁9例(9/18),鞍旁1例(1/18),桥小脑区1例(1/18)。肿瘤形态规则5例(5/18),形态不规则13例(13/18)。肿瘤边界清晰6例(6/18),边界不清12例(12/18)。其中13例(13/18)可见明显囊变或坏死。MRI平扫T_1WI多呈略低信号13例(13/18)、T_2WI多呈略高信号11例(11/18)。增强后不均匀强化13例(13/18),均匀强化3例(3/18),环形强化2例(2/18)。12例(12/18)可见"脑膜尾征"。瘤周见不同程度水肿13例(13/18),无水肿5例(5/18)。邻近颅骨破坏12例(12/18)。复发者1例(1/18)。结论恶性脑膜瘤的MRI表现具有一定特征性,结合临床正确分析其影像表现有助于提高术前诊断水平。Objective To explore the MRI characteristics of malignant meningiomas .Methods MRI data of 18 patients 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 adjacent dura were observed compared with the pathology .Results In 18 patients,meningiomas was mainly located at the convexity of brain and sagittal sinus in 7 cases （7/18） and 9 cases （9/18） respectively.5 cases （5/18） had regular shape, 13 cases （13/18） had irregular shape. The border was clear in 6 cases （6/18）, ill defined in 12 cases （12/18）.Homogeneous enhancement was seen in 3 cases （3/18）, and heterogeneous enhancement was seen in 13 cases （13/18）.13 cases （13/18） had obvious necrosis and cystic degener-ation.13 cases （13/18） had peritumoral brain edema in different degree .12 cases （12/18） showed dural tail sign .9 cases （9/18） invaded adjacent skull.1 case （1/18） had relapse.Conclusion Malignant meningiomas has special features on MRI and correct analysis of the imaging findings and clinical features can be helpful to improve the preoperative diagnosis level .

关 键 词：脑膜瘤 恶性 磁共振成像 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]