囊性脑膜瘤的影像、病理学特点及误诊原因研究  

Imaging and pathological features and misdiagnosis causes of cystic meningioma

作　　者：付强[1] 陈培培[2] 李绍山[1] 魏康康 王增亮[1] 刘波[1] 周庆九[1] FU Qiang;CHEN Pei-pei;LI Shao-shan(Department of Neurosurgery,First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院神经外科,乌鲁木齐830054 [2]新疆医科大学第一附属医院临床营养科,乌鲁木齐830054

出　　处：《临床神经外科杂志》2019年第4期345-349,共5页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81801232)

摘　　要：目的 探讨囊性脑膜瘤的影像学和病理学特点、误诊原因及手术治疗效果。方法 回顾性分析新疆医科大学第一附属医院神经外科手术并经病理证实的11例囊性脑膜瘤患者的临床资料。术后采用门诊及电话对患者进行随访。结果 11例患者中,术前误诊为胶质瘤7例、转移瘤3例、血管母细胞瘤1例;影像学Zee分型:Ⅰ型2例、Ⅱ型8例、Ⅲ型1例。11例患者均行手术治疗,其中simpsonⅠ级切除者5例、simpsonⅡ级切除6例;术后行伽玛刀放疗者5例。病理检查结果:8例患者为血管瘤型脑膜瘤WHOⅠ级,3例患者为非典型脑膜瘤WHOⅡ级。术后症状改善者9例,无变化1例,恶化1例;随访6个月~3年,11例患者均存活,1例患者肿瘤复发。结论 囊性脑膜瘤临床少见,术前容易误诊,其影像学表现和病理类型有助于确诊及指导手术治疗。Objective To explore the imaging and pathological features,misdiagnosis and surgical treatment of of cystic meningioma.Methods The clinical data of 11 patients of cystic meningioma with pathologic confirmation in the First Affiliated Hospital of XinJiang Medical University were analyzed retrospectively.The clinic and telephone follow-up were conducted.Results Of 11 patients,7 were misdiagnosed as glioma,3 metastatic tumor and 1 angioblastoma preoperatively.Zee classification showed type Ⅰ in 2 cases,type Ⅱ in 8 and type Ⅲ in 1.All cases were performed surgery.Of 11 patients,5 received Simpson I excision,6 simpson Ⅱ resection and 5 were followed with postoperative gamma knife radiotherapy.Pathological results showed 8 cases were angiomatous meningioma WHO Ⅰ grade and 3 cases were atypical meningioma WHO Ⅱ grade.Postoperative symptoms were improved in 9 cases,with no change in 1 and deterioration in 1.The follow-up period lasted from 6 months to 3 years.11 patients survived and 1 experienced recurrence of tumor.Conclusions Cystic meningioma is rare and easy to be misdiagnosed preoperatively.Understanding its imaging manifestations and pathological types is helpful for diagnosis and treatment.

关 键 词：囊性脑膜瘤 影像学 病理学 误诊 手术治疗 

分 类 号：R739.45[医药卫生—肿瘤]