中央区脑膜瘤术前影像学表现与手术分离度及临床疗效的相关性研究  

A correlation study of preoperative imaging findings of central meningiomas and surgical cleavage and clinical efficacy

作　　者：马春晓[1] 周伟[1] 李明[1] 闫兆月[1] 屈鸣麒[1] 步星耀[1] 

机构地区：[1]郑州大学人民医院神经外科,450003

出　　处：《中华神经外科杂志》2016年第8期810-814,共5页Chinese Journal of Neurosurgery

基　　金：河南省科技厅科技攻关项目（132102310196）

摘　　要：目的 探讨中央区脑膜瘤术前影像学特征与手术分离度的相关性,并对比分析不同手术分离度的临床疗效.方法 回顾性分析2006年2月至2014年2月郑州大学人民医院神经外科收治的97例中央区脑膜瘤的影像学特征与手术分离度的相关性.通过单因素分析检验肿瘤的影像学特征与手术分离度之间的关系.采用Kaplan-Meier生存分析法、多因素Logistic回归分析评估影像学参数能否预测手术分离度.应用Cox回归模型分析手术分离度与总生存期（0S）和无进展生存期（PFS）之间的关系.结果 单因素分析结果显示,瘤周水肿、与静脉窦的位置关系、皮质浸润和弥散加权成像（DWI）信号强度与手术分离度均具有明显的相关性（均P＜0.05）;而肿瘤的大小、边界、强化情况、钙化、囊变、脑膜尾征、邻近骨改变与手术分离度无关（P＞0.05）.多因素Logistic回归分析显示,皮质浸润是中央区脑膜瘤手术分离度最主要的独立预测因子（P＜0.01）,其他依次为DWI高信号、矢状窦旁、瘤周水肿（P＜0.01）.Kaplan-Meier分析结果表明,中央区Ⅰ度脑膜瘤患者的中位OS和中位PFS显著高于中央区Ⅱ度脑膜瘤患者.Cox回归模型分析显示,年龄、WHO病理级别和手术分离度可作为影响预后的独立预测因子（P＜0.05）.结论 术前影像学提供的瘤周水肿、与静脉窦的位置关系、皮质浸润和DWI信号强度可预测脑膜瘤手术分离度,而手术分离度与患者的预后相关.Objectives To investigate the correlation between preoperative imaging features of central meningiomas and surgical cleavage and to comparatively analyze the clinical efficacy of the different surgical cleavages. Methods From February 2006 to February 2014, the correlation between imaging features and surgical cleavage in 97 patients with center meningioma admitted to the Department of Neurosurgery, People ＂s Hospital of Zhengzhou University were analyzed retrospectively. The relationship between imaging features and surgical cleavage of the tumors were tested by the univariate analysis. Kaplan- Meier survival analysis and multivariate logistic regression analysis were used to assess whether the imaging parameters predicted the surgical cleavage. Cox regression model was used to analyze the relationship between surgical cleavage or overall survival OS） and progression free survival （PFS）. Results The result of single factor analysis showed that the relationships between the peritumoral edema and the position of venous sinus, the cortical infiltration and diffusion weighted imaging （DWI） signal intensity and surgical cleavage had obvious relevance （ all P 〈 0.05 ） ; and tumor size, border, enhancement, calcification, cystic change, dral tail sign, and adjacent bone changes were not associated with surgical cleavage （ P 〉 0.05 ）. Multivariate logistic regression analysis showed that cortical infihration was the most important independent predictor of surgical cleavage on central meningioma （P 〈 0.01 ）, others followed by DWI hyperintensity, parasagittal sinus, and peritumoral edema （P 〈 0.01 ）. The results of Kaplan-Meier analysis show that the median OS and median PFS in patients with the central grade Ⅱ meningioma. Cox regression model analysis showed that the age, WHO pathological grade, and surgical cleavage could be used as the independent predictive factors of influencing prognosis （ P 〈 0.05 ）. Conclusions The peritumoral edema provided by preoperative imaging, th

关 键 词：脑膜瘤 磁共振成像 手术分离度 临床疗效 

分 类 号：R739.45[医药卫生—肿瘤]