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MRI对颅内脑膜瘤的诊断价值研究

作者:陈 琪 李国强 李惊涛

所属单位:陕西省汉中市中心医院神经外科(陕西 汉中 723000)

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摘要

目的 探讨MRI对颅内脑膜瘤的 临床诊断价值。方法 回顾性分析我院 2014年1月-2015年12月期间接收并经手 术病理确诊的96例脑膜瘤患者的MRI检 查资料,并对脑膜瘤患者的病变大小、 位置、形态等MRI影像特征、检出率及 其病理特点进行综合分析。结果 96例 脑膜瘤患者均为单发肿瘤,其中肿瘤位 于顶部大脑凸面、前颅底、中颅凹底、 后颅底、大脑镰旁的患者分别有39例、 23例、18例、10例、6例;以手术病理确 诊结果为标准,MRI对本组脑膜瘤肿瘤 的检出率为91.7%;肿瘤的形态主要为 圆形或椭圆形、半月形,直径在3-5cm 之间,大小在1.2cm×1.0cm×1.3cm6.2cm×4.6cm×6.1cm之间;在T1WI呈等 信号58例,呈稍低信号29例,呈混杂不均 匀信号9例;在T2WI呈稍高信号46例,呈 等信号21例,呈低信号21例,呈混杂不均 匀信号8例;增强扫面后,明显强化的有 88例,强化不均匀有8例;67例可见明显 的脑膜尾,38例肿瘤周围显示有水肿带, 63例肿瘤在T1WI上可见环状低信号,27例 局部颅盖骨增厚。结论 MRI在脑膜瘤的诊 断过程中,不仅能够定位诊断出肿瘤的发 育部位、大小、形态,还能通过综合分析 脑膜瘤的MRI影像表现与病理特点进行定 性诊断,具有重要的临床应用价值,值得 进一步推广和应用。

Objective To investigate the clinical value of MRI in the diagnosis of intracranial meningioma. Methods Retrospective analysis of MRI data of 96 patients with meningioma confirmed by surgery and pathology in our hospital from January 2014 to December 2015. And comprehensive analysis of the lesion size, location, morphology and other MRI imaging features, detection rate and pathological characteristics of patients with meningioma. Results 96 cases of patients with meningioma were solitary tumors. The tumor located in the top convexity, anterior skull base, middle cranial fossa, after skull base, falx patients respectively was 39 cases, 23 cases, 18 cases, 10 cases, 6 cases. The detection rate of MRI in this group was 91.7%, which was confirmed by surgery and pathology. Tumor shape is round or oval, half moon shape, diameter between 3-5cm, size between 1.2cm×1.0 cm×1.3 cm to 6.2 cm×4.6 cm×6.1cm. T1WI was in 58 cases, showed slightly low signal in 29 cases, 9 cases showed mixed uneven signal; T2WI was slightly high signal in 46 cases, 21 cases showed signal, 21 cases showed low signal, 8 cases showed mixed signal. After enhanced scanning, 88 cases were obviously enhanced, and 8 cases were inhomogeneous enhancement. Around 38 cases of tumors showed edema, 63 cases of tumor in T1WI showed hypointense, 27 cases of partial calvarial thickening. Conclusion MRI in the diagnosis of meningioma, not only to locate the location and size of the tumor diagnosis, size, shape, but also through the comprehensive analysis of the MRI imaging manifestations and pathological features of the qualitative diagnosis, has important clinical application value. It is worthy of further promotion and application.

【关键词】MRI;颅内脑膜瘤;影像学

【中图分类号】R445.2;R739.45

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.04.008

前言

颅内脑膜瘤为颅内常见的肿瘤之一,约占颅内原发性肿瘤的 15%~20%[1],由脑膜组织形成,肿瘤大多起源于蛛网膜内皮细胞[2], 可发于颅内任何部位,好发生于蛛网膜颗粒与蛛网膜绒毛处,临床主 要表现为剧烈头疼、呕吐、视神经功能衰弱等症状[3]。报道显示,脑 膜瘤多发于成人,高峰年龄为40岁~60岁,以女性多见[4],且发病率 较高,仅次于神经胶质瘤。研究表明,术前充分了解脑瘤膜的影像学 特征、临床准确诊断,对于手术方案及治疗手段的选择起到良好的指 导作用[5]。目前,影像学检查是脑膜瘤的最佳临床诊断手段,其中磁 共振成像(MRI)技术由于具有分辨率高、多轴位成像的特点[6],在对脑 膜瘤的临床诊断中得到了越来越广泛的应用。为了探讨MRI在脑膜瘤诊 断中的应用价值,本文将我院近两年来收治的96例脑膜瘤患者的临床 资料和MRI资料进行整理分析,现具体报告如下。