颅内横纹肌样脑膜瘤的磁共振成像及病理学特征  

Magnetic resonance imaging and pathological features of intracranial rhabdoid meningiomas

作　　者：段芙红[1] 白洁[1] 张勇[1] 程敬亮[1] DUAN Fu-hong;BAI Jie;ZHANG Yong;CHENG Jing-liang(Department of Magnetic Resonance Imaging,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052

出　　处：《新乡医学院学报》2018年第11期991-993,共3页Journal of Xinxiang Medical University

基　　金：河南省科技厅重点攻关项目(编号:112102310703)

摘　　要：目的探讨颅内横纹肌样脑膜瘤(RM)的磁共振成像(MRI)及病理学特征。方法回顾性分析2010年5月至2017年9月于郑州大学第一附属医院收治的5例RM患者的MRI影像及病理资料。结果 5例RM中,位于额部脑凸面1例,颞叶2例,枕叶1例,鞍旁1例。RM形态不规则4例,类圆形1例;边界不清5例,其中伴坏死囊变1例。肿瘤实质部分T1加权像(Tl WI)呈等信号5例,T2加权像(T2WI)呈等信号3例、稍低信号1例、混杂信号1例,扩散加权成像(DWI)呈高或稍高信号4例,增强扫描显示明显不均质强化4例。中度瘤周脑水肿1例,轻度瘤周脑水肿1例,硬膜尾征2例,骨质破坏并向颅外侵犯1例。5例光镜下肿瘤细胞均有横纹肌样特点。免疫组织化学染色显示,肿瘤细胞上皮膜抗原和波形蛋白均阳性,胶质纤维酸性蛋白和S-100均阴性,Ki-67阳性率为10%~80%。结论颅内RM有一定的MRI及病理学特征,总结其特点有助于提高术前诊断准确率。Objective To investigate the magnetic resonance imaging（MRI） and pathological features of intracranial rhabdoid meningiomas（RM）.Methods The MRI and pathological data of 5 patients with RM in the First Affiliated Hospital of Zhengzhou University from May 2010 to September 2017 were retrospectively analyzed.Results Among the five cases,the tumor was located in frontal brain convexity in one case,temporal lobe in two cases,occipital lobe in one case and parasellar region in one case.The shape of RM was irregular in four cases and round in one case.The tumor borders were blurred in five cases,and necrotic cystic degeneration in one case.Necrotic cystic change was noted in one case.The T1 weighted imaging（TlWI） of tumor parenchyma showed isointensity in five cases.The T2 weighted imaging（T2WI） of tumor parenchyma showed isointensity in three cases,slightly hypointensity in one case,mixed signal in one case.Diffusion weighted imaging（DWI） showed hyperintense or slightly hyperintense in four cases,and enhancement scanning showed significant heterogeneous enhancement in four cases.Moderate peritumoral edema was found in one case,and mild peritumoral edema in one case.Two cases showed dural tail sign,and one case had bone destruction with extracranial invasion.5 cases showed Rall like characteristics.The tumor cells had rhabdoid-like features in 5 cases under the light microscope.Immunohistochemical staining showed that both epithelial membrane antigen and vimentin were positive,glial fibrillary acidic protein and S-100 were negative,and the positive rate of Ki-67 was 10%-80% in the tumor cells.Conclusion Intracranial RM has certain MRI and pathological characteristics.Summarizing its characteristics is helpful to improve the accuracy of preoperative diagnosis.

关 键 词：中枢神经系统 横纹肌样脑膜瘤 磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤]