3D-CE-TOF-MRV对上矢状窦旁脑膜瘤术前评估的应用价值  

The value of 3D-CE-TOF-MRV technique in evaluating the preoperative parasagittal sinus meningioma

作　　者：吴瑜 杨烁慧[1] 陆方[1] 詹松华[1] 王蔚[2] 王明磊[3] WU Yu;YANG Shuohui;LU Fang;ZHAN Songhua;WANG Wei;WANG Minglei(Department of Radiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China;Department of Radiology,People’s Hospital of Shanghai Putuo District,Shanghai 200060,P.R.China 3.Department of Neurosurgery,People’s Hospital of Shanghai Putuo District,Shanghai 200060,P.R.China)

机构地区：[1]上海中医药大学附属曙光医院放射科,上海201203 [2]上海市普陀区人民医院放射科,上海200060 [3]上海市普陀区人民医院神经外科,上海200060

出　　处：《医学影像学杂志》2020年第4期533-536,共4页Journal of Medical Imaging

摘　　要：目的探讨三维对比增强时间飞跃法磁共振静脉成像(three dimensional contrast enhance time of flight magnetic resonance venography,3D-CE-TOF-MRV)技术对上矢状窦旁脑膜瘤术前静脉窦侵犯评估的应用价值。方法回顾性分析经手术治疗的上矢状窦旁脑膜瘤患者26例,共26枚肿瘤,所有患者术前行三维对比增强MR静脉血管成像(three dimensional contrast enhance magnetic resonance venography,3D-CE-MRV)及3D-CE-TOF-MRV检查。对比观察其在显示肿瘤染色、与上矢状窦关系的差异。以术中所见肿瘤侵犯静脉窦的程度为标准,计算诊断准确度,并采用配对2检验比较3D-CE-MRV及3D-CE-TOF-MRV在评估肿瘤对上矢状窦侵犯程度的差异的统计学意义。结果19枚肿瘤在3D-CE-MRV上可见肿瘤染色,26枚在3D-CE-TOF-MRV显示清晰的肿瘤染色。术中见5枚肿瘤与上矢状窦分离(0级),9枚与上矢状窦壁黏连(1级),9枚突入上矢状窦腔(2级),3枚填满上矢状窦腔(3级),3D-CE-MRV假阴性1例,假阳性8例,准确度65%,3D-CE-TOF-MRV假阴性2例,假阳性1例,准确度88%,差异有统计学意义,P=0.021。结论3D-CE-TOF-MRV技术清晰显示其对相邻静脉窦侵犯程度,在显示肿瘤对上矢状窦侵犯程度方面优于3D-CE-MRV,可以为脑膜瘤术前评估提供准确的影像信息。Objective To explore the value of three dimensional contrast enhance time of flight magnetic resonance venography(3D-CE-TOF-MRV)technique in evaluating the invasion degree of the preoperative parasagittal sinus meningiomas.Methods A retrospective analysis was conducted on 26 patients with parasagittal sinus meningiomas preoperation.All patients were examined preoperatively with 3D-CE-MRV and 3D-CE-TOF-MRV to explore the tumor stain,relationship between tumor and superior sagittal sinus.Basing on the intraoperative findings,accuracy rate of diagnosis was calculated.we used McNemar test to compare the statistical difference of the sinus invasion degree discovering on 3D-CE-MRV and 3D-CE-TOF-MRV.Results 19 tumors were shown tumor stain on 3D-CE-MRV,while all tumor stains were clearly displayed on 3D-CE-TOF-MRV.According to the findings of operations,5 cases of meningiomas separated from the sagittal sinus(degree 0),9 cases adhered to the wall of sinus(degree 1),9 cases partially invaded the sinuses and the sinuses were still unobstructed(degree 2),3 cases absolutely invaded the sagittal sinuses and the sinuses were completely obstructed(degree 3).Compared with these finds,there were 1 false-negative case,8 false positive cases with the accuracy rating 65%in 3D-CE-MRV,and 2 false-negative cases,and 1 false positive case with the accuracy rating of 88%in 3D-CE-TOF-MRV.The difference was statistically significant,P=0.021.Conclusion 3D-CE-TOF-MRV can three-dimensional display the parasagittal sinus meningioma and is more effective to evaluate the invasion degree of sinus than on 3D-CE-MRV,which may offer more important image information before surgical treatment of parasagittal sinus meningioma.

关 键 词：脑膜瘤 静脉窦 术前评估 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]