中枢神经系统血管外皮细胞瘤与脑膜瘤CT、MRI鉴别诊断价值研究  

Value of CT and MRI in Differential Diagnosis of Hemangiopericytoma and Meningiomas in Central Nervous System

作　　者：张涛[1] 彭华[1] 杨彬彬[1] 李峥[1] ZHANG tao;PENG Hua;YANG bin-bin;LI Zheng(Department of Neurosurgery,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan Province,China)

机构地区：[1]川北医学院附属医院神经外科,四川南充637000

出　　处：《中国CT和MRI杂志》2022年第5期13-15,共3页Chinese Journal of CT and MRI

基　　金：四川省卫生和计划生育委员会科研课题(17PJ174)。

摘　　要：目的 分析CT、MRI鉴别诊断中枢神经系统血管外皮细胞瘤(HPC)与脑膜瘤的临床价值。方法 选取本院2016年4月至2019年9月手术或病理学活检证实的HPC18例及脑膜瘤47例患者作为研究对象,对比不同检查肿瘤形态、坏死、强化程度等特征。结果 HPC肿瘤外形以波浪状分叶多见,脑膜“尾”征较少见,肿瘤内多见囊变坏死、血管流空信号,增强扫描强化明显,DWI上以等低信号为主、多无钙化;脑膜瘤上述影像学征象则与HPC相反,两者肿瘤外形以波浪状分叶,肿瘤内多见囊变坏死、血管流空信号、增强扫描、临近颅骨无增生、DWI信号6个因素比较差异显著(P<0.05),而脑膜“尾”征、钙化2个因素比较无明显差异(P>0.05)。结论 CT与MRI检查均可有效诊断HPC与脑膜瘤,两者影像学征象具有相似性,但仍各具其特征性。结合患者影像学特征、对比MRI、CT征象可有效提高鉴别诊断准确率。Objective To analyze the clinical value of CT and MRI in differential diagnosis of hemangiopericytoma(HPC) and meningiomas in the central nervous system. Methods 18 patients with HPC and 47 patients with meningiomas confirmed by surgery or pathological biopsy from April 2016 to September 2019were selected as the research subjects. The features such as tumor shape, necrosis, and degree of enhancement in different examinations were compared. Results HPC tumors are more common in wavy lobes, and meningeal tail signs are less common. In tumours, cystic necrosis and vascular flow empty signals are more common. The enhanced scan showed obvious enhancement. On DWI, low signals are predominant and there are no calcification. The imaging signs of meningiomas above mentioned are opposite to HPC. The differences in the wavy lobes of tumor, cystic necrosis mainly in tumor,vascular flow empty signals, enhanced scan, no hyperplasia of the adjacent skull, and DWI signal are significant between them(P<0.05). However there were no significant differences in meningeal tail sign and calcification(P>0.05). Conclusion Both CT and MRI examinations can effectively diagnose HPC and meningioma. The imaging signs of the them are similar, but they still have their own characteristics. Combining the imaging characteristics of patients and comparing MRI and CT signs can effectively improve the accuracy of differential diagnosis.

关 键 词：中枢神经系统血管外皮细胞瘤 脑膜瘤 CT MRI 

分 类 号：R445.3[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]