摘要
目的 探讨头颅MRI强化扫描对 脑膜瘤的临床诊断效果。方法 选取我院 2014年3月-2015年12月期间收治的80例 脑膜瘤患者作为研究对象,均行头颅MRI 平扫及强化扫描,观察病变的位置、大 小、形态、信号、强化方式等影像学表 现,并结合临床资料和手术病理结果进 行综合分析。结果 80例患者经手术及 病理确诊均为单发病灶,其中肿瘤位于 顶部大脑凸面、矢状窦旁、蝶骨嵴、大 脑镰旁、侧脑室、桥小脑角的分别有33 例、17例、9例、14例、2例、5例,尺寸 在1.3×1.0×1.2cm-6.3×4.8×6.2cm之 间,形态主要呈圆形或类圆形、半月形; MRI对所有病灶的检出符合率为91.25%, 与手术及病理诊断结果比较,差异无统计 学意义(P>0.05);脑膜瘤的MRI信号特点 是在T1WI上多呈等信号,在T2WI上多呈稍 高信号,少数在T1WI和T2WI上均呈混杂不 均匀信号,强化扫面后,大多数病灶显示 明显强化,少数强化不均匀。结论 经头 颅MRI扫描,尤其是MRI强化扫描,脑膜瘤 在的信号特点及表现都具有特征性,且 头颅MRI强化扫描对病灶的检出符合率较 高,具有定位及定性诊断的作用,在临床 中可以作为诊断脑膜瘤的重要影像学手 段,值得进一步推广和应用。
Objective To investigate the effect of MRI enhanced scanning in the diagnosis of meningioma. Methods 82 cases of meningioma patients in our hospital were selected from March 2014 to December 2015. MRI scan and enhanced scan were performed in all patients. The position, size, shape, signal and enhancement of the lesion were observed. And combined with clinical data and surgical pathology results to make comprehensive analysis. Results 80 cases were confirmed by operation and pathological diagnosis were single lesions. The beside tumor located at the top of the cerebral convexity, parasagittal sinus, sphenoid ridge, falx cerebri, lateral ventricle, cerebellopontine angle patients were 33 cases, 17 cases, 9 cases, 14 cases, 2 cases, 5 cases. The tumor size between 1.3×1.0×1.2cm-6.3×4.8×6.2cm, tumor morphology were round or oval and half moon. The rate of MRI was 91.25% for all lesions. The difference was not statistically significant (P>0.05) compared with the results of surgery and pathology. The MRI signal of meningioma is characterized by a large signal on the T1WI and slightly high signal on T2WI. The minority in T1WI and T2WI showed mixed inhomogeneous signal. After enhancement scanning, most lesions showed marked enhancement, and a few showed that the enhancement was not uniform. Conclusion After the skull MRI scanning, especially MRI enhanced scan, the signal features and manifestations of meningiomas are characteristic. And the MRI enhanced scan of the skull has a high rate of coincidence rate, which has the function of localization and qualitative diagnosis. MRI enhanced scan can be used as an important imaging tool in the clinical diagnosis of meningioma. It is worthy of further promotion and application.
【关键词】MRI强化扫描;脑膜瘤;手术 病理;诊断效果
【中图分类号】R739.45
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.08.010
前言
脑膜瘤是起源于脑膜及脑膜间隙的衍生物,生长较慢,病程较 长,其发病率占颅内原发性肿瘤的15%~20%[1-2],多发于成年人,高峰 年龄在50岁左右,以女性患者居多[3]。临床往往以头疼和癫痫为首发 症状,随着肿瘤的位置和大小的不同,患者还可能出现视力、嗅觉、 听觉障碍及肢体运动障碍等症状。报道显示,当脑膜瘤发生在静脉窦 旁时,病灶易侵犯窦壁和窦腔,同时累及周围静脉系统,若手术过程 中稍稍处理不当,就会引起患者脑组织水肿,从而导致颅内增压,甚 至死亡[4]。因此,术前充分认识脑瘤膜的影像学表现、准确诊断,对 于脑瘤膜的手术方案及治疗手段的选择具有非常重要的临床意义。MRI 扫描由于具有较高的软组织分辨率和多轴位成像的特点[5-6],在脑膜瘤 的临床诊断中得到了越来越多的应用。然而,由于脑膜瘤的MRI表现具 有多样性,极易出现误诊,为此本文对我院2014年3月~2015年12月期 间收治的80例脑膜瘤患者的临床资料、MRI检查资料进行综合分析,旨 在探讨头颅MRI强化扫描对脑膜瘤的诊断效果,从而为临床诊断提供参 考依据,现具体报告如下。
中国CT和MRI杂志
第15卷, 第 8 期
2017年08月
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