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论著-头颈部

颅内血管周细胞瘤与脑膜瘤MR影像对比分析

作者:王 莉 曲海源

所属单位:中国医科大学附属第一医院放射科(辽宁 沈阳 110001)

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摘要

目的 研究颅内血管周细胞瘤 (HPC)与脑膜瘤的MRI影像特征,并进行 对比分析。方法 选取经手术病理证实的 HPC 13例及脑膜瘤102例,通过?2检验、 t检验、秩和检验及Logistic回归分析等 分析两组肿瘤的MR特征及临床指标差异。 结果 肿瘤形态(连续校正b=7.916)、肿瘤 内血管流空信号(连续校正b=11.212)、肿 瘤内囊变坏死信号(连续校正b=10.992)、 肿瘤附着硬膜类型(连续校正b=7.593)、 硬膜尾征(χ2 =12.731)、肿瘤增强均匀性 (χ2 =10.093)等因素在HPC组与脑膜瘤组 之间差异有显著的统计学意义,P﹤0.01; 患者性别(连续校正b=4.746)、T1WI信号 强度(连续校正b=5.648)、T2WI信号强度 (连续校正b=6.510)、肿瘤最大径(双侧检 验P=0.034)等因素P﹤0.05。Logistic回归 分析中,变量“肿瘤内血管流空信号”P ﹤0.01,变量“肿瘤内囊变坏死信号”、 “肿瘤附着硬膜类型”、“硬膜尾征”、 “T2WI信号强度”P﹤0.05。结论 颅内血 管周细胞瘤和脑膜瘤MR影像存在差异, 充分掌握两者的影像特征可提高术前诊断 率,为临床提供更多依据。

Objective To study and compare the MRI imaging characteristics of intracranial hemangiopericytoma and meningioma. Methods Thirteen cases of HPC and 102 cases of meningioma which approved by operation and pathology were selected.The MRI appearances and clinical features of tumors between the two groups were reviewed retrospectively, the data were evaluated by useing χ2 test、T test、rank sum test and Logistic Rgression. Results Shape of tumor (Continuity Correctionb=7.916), signal voids of vessel in tumor (Continuity Correctionb=11.212), cystic and necrosis degeneration in tumor (Continuity Correctionb =10.992), the type of dural attachment (Continuity Correctionb=7.593), dural tail sign (χ2 =12.731) and homogeneous degree of tumor after contrast enhancement (χ2 =10.093) were significant (P﹤0.01) different in statistics between intracranial hemangiopericytoma group and meningioma group. In addition,there was significant difference (P﹤0.05) between the two groups with sex (Continuity Correctionb=4.746), T1WI signal intensity (Continuity Correctionb=5.648), T2WI signal intensity (Continuity Correctionb=6.510) and the largest diameter of tumor (P=0.034). In Logistic regression analysis, signal voids of vessel in tumor showed significant difference(P ﹤0.01) between the two groups, and cystic and necrosis degeneration in tumor、the type of dural attachment、dural tail sign、T2WI signal intensity also showed significant difference (P﹤0.05). Conclusion The MRI findings were different between HPC and meningioma, and understanding the MRI characteristic of HPC and meningioma would provide more useful imaging basis to clinic.

【关键词】血管周细胞瘤;脑膜瘤;磁共振成像;对比分析

【中图分类号】R739.4;R445.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.02.003

前言

颅内血管周细胞瘤(Hemangiopericytoma, HPC)又称血管外皮瘤, 可发生于全身任何部位[1],好发于皮肤、四肢肌肉骨骼及腹膜后,颅 内发生率较低,约占中枢神经系统肿瘤的0.29%~1.00%[2]。该肿瘤具 有侵袭性强、血运丰富、术中出血多、难以全切等特点,增加了肿瘤 复发与转移的可能性;其影像表现易与脑膜瘤混淆,误诊率高,故术 前正确诊断非常重要。笔者搜集了我院2011~2014年经手术病理证实 的血管周细胞瘤13例和脑膜瘤102例的影像及临床资料,旨在提高对本 病的认识,现报道如下。