术前多模态MRI检查与颅内脑膜瘤患者术后复发及高组织学分级的关系  

Preoperative multimodal MRI was associated with postoperative recurrence and high histological grade in patients with intracranial meningiomas

作　　者：黄德尤[1] 廖莎[1] 卢德伟[1] 李娜[1] 罗起胜[2] 陆海善[3] 李滢 HUANG Deyou;LIAO Sha;LU Dewei;LI Na;LUO Qisheng;LU Haishan;LI Ying(Department of Radiology,Affiliated Hospital of Youjiang Medical College for Nationalities,Baise 533000,China)

机构地区：[1]右江民族医学院附属医院放射科,广西百色533000 [2]右江民族医学院附属医院神经外科,广西百色533000 [3]右江民族医学院附属医院病理科,广西百色533000 [4]湖南省常德市第一人民医院影像科,湖南常德415003

出　　处：《实用医学杂志》2021年第2期201-204,共4页The Journal of Practical Medicine

基　　金：广西壮族自治区卫生和计划生育委员会科技计划项目(编号:Z2016425);百色市科学研究与技术开发计划项目基金(编号:百科计20140917)。

摘　　要：目的评价术前多模态MRI检查与颅内脑膜瘤患者术后复发及高组织学分级的关系。方法选择2016年1月至2019年6月我院手术治疗的脑膜瘤患者100例,术后根据WHO脑膜瘤组织学分级标准分为低级别组(Ⅰ-Ⅱ级)53例和高级别组(Ⅲ-Ⅳ)47例,术后随访观察1年,复发患者为18例(复发组),未复发患者为82例(未复发组),所有患者术前均行常规及增强磁共振成像(MRI)、磁共振张量成像(DTI)及磁共振波谱成像(MRS)检查,采用Logistic回归分析高级别组和复发组脑膜瘤患者相关影响因素。结果复发组与未复发组在肿瘤部位、肿瘤大小、边界、强化灶、ADC值、FA值、Cho/NAA、Cho/Cr、NAA/Cr上比较,差异有统计学意义(P<0.05);高级别组与低级别组在肿瘤大小、边界、强化灶、水肿程度、ADC值、FA值、Cho/NAA、Cho/Cr、NAA/Cr上比较,差异有统计学意义(P<0.05);多因素Logistic回归分析示,肿瘤大小、边界、ADC值、FA值及Cho/NAA值是脑膜瘤复发患者的独立危险因素(P<0.05);肿瘤大小、强化灶、ADC值、FA值及Cho/NAA值是高级别脑膜瘤患者的独立危险因素(P<0.05)。结论多模态MRI检查有助于判断颅内脑膜瘤患者术后复发及高组织学分级,具有推广应用价值。Objective To evaluate the correlation between preoperative multimodal MRI and postoperative recurrence and high histological grade in patients with intracranial meningiomas.Methods One hundred patients with meningioma treated in our hospital from January 2016 to June 2019 were selected,according to the WHO after meningioma histological classification standard is divided into low level group(Ⅰ~Ⅱ)53 cases and high level group(Ⅲ~Ⅳ)47 cases,postoperative follow⁃up observation lasted for 1 year.There were 18 patients with recurrence(recurrence group)and 82 patients without recurrence(non⁃recurrence group);All patients underwent conventional and enhanced magnetic resonance imaging(MRI),magnetic resonance tensor imaging(DTI)and magnetic reso⁃nance spectroscopy(MRS)before surgery;Logistic regression was used to analyze the related influencing factors in patients with high⁃grade and recurrent meningioma.Results Compared with the non⁃recurrent group,there were statistically significant differences in tumor site,tumor size,boundary,enhancement foci,ADC value,FA value,Cho/NAA,Cho/Cr,NAA/Cr(P<0.05);The tumor size,boundary,enhancement foci,degree of edema,ADC value,FA value,Cho/NAA,Cho/Cr,NAA/Cr were significantly different from those of the low⁃grade group(P<0.05);Multivariate Logistic regression analysis showed that tumor size,boundary,ADC value,FA value and Cho/NAA value were independent risk factors of meningioma recurrence(P<0.05);Tumor size,enhancement foci,ADC value,FA value and Cho/NAA value were independent risk factors of high⁃grade meningioma(P<0.05).Conclusion Multimodal MRI is helpful to determine postoperative recurrence and high histological grade in patients with intra⁃cranial meningioma.

关 键 词：磁共振成像 脑膜瘤 复发 组织学分级 

分 类 号：R445[医药卫生—影像医学与核医学]