不典型脑膜瘤的影像表现与病理对照  

Imaging Findings and Pathology of Atypical Meningiomas

作　　者：余丁福 YU Ding-fu(Department of Medical Imaging,Jin'an District,Fuzhou,Fujian Province,350000 China)

机构地区：[1]福建省福州市晋安区医学影像科

出　　处：《中外医疗》2019年第35期25-28,共4页China & Foreign Medical Treatment

摘　　要：目的探讨不典型脑膜瘤的影像学表现并与病理对照,以期提高其认识。方法方便收集该院2015年1月—2018年12月经手术病理证实的影像表现不典型脑膜瘤15例。15例均行MRI平扫、增强及弥散加权成像(DWI)扫描,1例同时行CT平扫,3例行氢质子磁共振波谱(1H-MRS)扫描,2例行磁共振灌注(PWI)扫描。结果15例病灶均为单发,仅部位不典型的5例,其中松果体区2例,眼眶、斜坡及右侧侧脑室三角区各1例,肿块信号均匀;仅信号或密度不典型的3例,分别位于右侧枕部、右顶部、左颞部,肿块信号混杂,伴有囊变、出血及钙化;信号及部位均不典型者的7例,其中2例病灶位置较深,分别位于右侧额部、右侧颞部,与脑实质肿瘤难以鉴别,余5例均位于侧脑室内,3例位于侧脑室三角区,2例位于侧脑室前角,肿块信号混杂,部分可见囊变。增强表现:仅2例可见明显脑膜尾征。信号均匀者,呈明显全瘤型强化;信号不均匀者,实性部分明显强化。1H-MRS表现:3例肿块胆碱(CHO)峰明显增高,N-乙酰天门冬氨酸(NAA)峰缺失。PWI表现:2例行灌注成像者均表现为高灌注。结论不典型脑膜瘤影像表现差异性大,运用多种影像学技术综合分析,有助于提高诊断的准确率。Objective To investigate the imaging findings of atypical meningioma and contrast with the pathology in order to improve their understanding.Methods Convenient collect 15 cases with their imaging findings showed atypical meningioma,which confirmed by surgical pathology in our hospital from January 2015 to December 2018.15 cases were performed in MRI plain scan,enhanced and diffusion weighted imaging,in which 1 case underwent CT plain scan,3 cases underwent proton magnetic resonance spectroscopy(1H-MRS),and 2 cases underwent magnetic resonance perfusion(PWI)scans.Results The lesions of 15 cases were solitary.There are 5 cases untypical only in different parts,in which 2 cases were in pineal region and the other 3 cases were in orbital,slope and right trigone of lateral ventricle respectively,also the tumor signals were homogeneous;Only 3 cases of signal or density were not typical,which were located in the right side of the occipital,right top,left temporal,tumor signal mixed,with cystic degeneration,hemorrhage and calcification;7 cases are not typical in signal and parts,in which 2 cases lesions in deeper location located in right frontal,right temporal,and difficult to identify to brain parenchymal tumors.Other 5 cases were in the lateral ventricle,in which 3 cases located in the lateral ventricle trigone and 2 cases located in the anterior horn of the lateral ventricle with mixed signal and parts of cystic change.The enhanced performance was that only 2 cases showed obvious dual tail sign.The signal was uniform,which was obviously full of tumor type enhancement;the signal was not uniform,in which the real part was obviously strengthened.1H-MRS performance:the choline peak of 3 cases were significantly increased and the NAA peak was absent.PWI performance:2 patients were performed perfusion imaging with high perfusion.Conclusion Atypical meningioma image has large difference and using a variety of comprehensive analysis of imaging technology can help to improve the diagnostic accuracy.

关 键 词：中枢神经系统 脑膜瘤 磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤]