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颅内脑膜瘤的CT影像特点

作者:张宝明 吴灿祥 陈伟斌 高利红

所属单位:广东省中山市三乡医院放射科(广东 中山 528463)

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摘要

目的探讨颅内脑膜瘤CT表现, 并提高其诊断准确率。方法 回顾性分析 55例经病理证实的脑膜瘤临床及影像资 料,与手术、病理结果进行对照,总结、 归纳脑膜瘤CT影像特点。结果 肿瘤呈高 密度者46例,呈等密度5例,呈混合密度 有4例,邻近颅骨出现骨质增生硬化29 例,瘤周水肿7例,45例肿瘤边缘清楚, 10例肿瘤组织与周围脑组织边缘不清。增 强扫描后病灶明显均匀强化者47例,明显 不均匀强化2例,轻度强化3例,强化不明 显2例,肿瘤周边薄层环状强化影1例。结 论 脑膜瘤典型CT表现为位于脑外,呈宽 基底与硬脑膜或颅骨相连,呈等或稍高密 度、较均匀,增强后明显均匀强化,抓住 以上特点有助于术前明确诊断。

Objective To explore the CT imaging features of intracranial meningiomas, and improve the diagnostic accuracy. Methods The clinical and imaging data of 55 cases of intracranial meningiomas which confirmed by pathology were analyzed retrospectively, and compared with surgery and pathology, and summarize the CT imaging features of intracranial meningiomas. Results Forty-six cases showed high density, 5 showed isointensity, and 4 were mixed density, hyperostosis osteosclerosis of the skull could be seen in twenty-nine cases; edema around the tumor in twenty-two cases. Forty-five cases of tumor with clear edge, ten cases of tumor with blurry edge. 47 cases showed obvious homogeneous enhancement after enhanced, and 2 had inhomogeneous enhancement; three cases showed mild enhancement; two cases had no enhancement. Ring-like enhancement could be seen around the tumor. Conclusion The classical CT imaging features of the intracranial meningiomas is that the lesion located out of the brain, attached to the dura with wide substrate, showed iso-intensity or high density, and had obvious homogeneous enhancement after enhanced.

【关键词】脑膜瘤;多层螺旋CT;诊断

【中图分类号】R739.45;R445.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2015.07.007

前言

脑膜瘤是一种生长缓慢的脑外肿瘤,占颅内原发肿瘤的 15%~18%,绝大多数为良性,一般将其分为内皮细胞型、纤维型、血 管型、化生型及恶性脑膜瘤,以前二者多见[1,2]。临床上早期常无明显 症状,晚期出现颅内压增高。本文回顾性分析我院55例病理确诊的脑 膜瘤患者多层螺旋CT(MSCT)影像,总结颅内脑膜瘤特征性CT表现,提 高影像科医生诊断准确率。