【摘要】 目的探讨WHO脑膜瘤分级中各级脑膜瘤MRI表现的差异。方法回顾性分析了经手术及病理证实的31例Ⅱ级及15例Ⅲ级脑膜瘤MRI表现,并与51例Ⅰ级脑膜瘤MRI表现进行对照分析。结果Ⅰ级脑膜瘤大部分为类球型,少数为分叶状,Ⅱ级脑膜瘤中分叶状所占比率较Ⅰ级脑膜瘤高,Ⅲ级脑膜瘤中绝大部分为分叶状,少数为类球形,差异具有统计学意义(P=0.0400)。Ⅰ、Ⅱ、Ⅲ级脑膜瘤肿瘤最大径差异无统计学意义(P=0.7790)。Ⅰ、Ⅱ、Ⅲ级脑膜瘤MRI信号不均匀者所占比例差异具有统计学意义(P=0.0150),不均匀强化所占比率差异具有统计学意义(P=0.0011)。硬膜尾征在Ⅰ、Ⅱ、Ⅲ级脑膜瘤中发生率差异无统计学意义(P=0.0579)。Ⅰ、Ⅱ、Ⅲ级脑膜瘤黑环征不完整或无黑环征者所占比率差异具有统计学意义(P=0.0182)。瘤周囊肿及瘤周水肿的发生率在各级脑膜瘤间的差异无统计学意义(P>0.05)。结论根据脑膜瘤MRI表现,脑膜瘤形状,MRI信号均匀程度,强化均匀程度可作为脑膜瘤分级的鉴别依据。更多还原

【Abstract】 Objective To investigate the differences in magnetic resonance imaging features among the WHO grade Ⅰ,Ⅱ and Ⅲ meningiomas.Methods We retrospectively studied the Magnetic Resonance Imaging features of WHO grade Ⅱ(31 cases) and WHO grade Ⅲ(15 cases) meningiomas,which were compared with WHO grade Ⅰ meningiomas(51 cases).Results The shapes of WHO grade Ⅰ meningiomas were predominantly rounded.The rate of lobular shape of WHO grade Ⅱ meningiomas was higher than that of WHO grade Ⅰ meningiomas.While most of the shapes of WHO grade Ⅲ meningiomas were lobular(P=0.0400).The largest diameters of WHO grade Ⅰ,Ⅱ and Ⅲ meningiomas were 4.6cm,4.5cm and 4.8cm respectively(P=0.7790).WHO grade Ⅰ,Ⅱ and Ⅲ meningiomas with heterogeneous intensity 73.3%(P=0.0150),and with heterogeneous contrast enhancement respectively(P=0.0011).Dural tail could be found in WHO grade Ⅰ,Ⅱ and Ⅲ meningiomas(P=0.0579).There are partial or complete disappearance of the peritumoral band in WHO Ⅰ,Ⅱ and Ⅲ(P=0.0002).The rates of intratumoral cysts of WHO grade Ⅱ and grade Ⅲ meningiomas are higher than that of WHO grade Ⅰ meningiomas.There are no significant differences in peritumoral cysts and peritumoral edema association with meningiomas amoung WHO grade Ⅰ,Ⅱ and Ⅲ meningiomas.Conclusions The shapes of WHO grade Ⅰ meningiomas are predominantly rounded.The rates of lobular shape of WHO grade Ⅱ and Ⅲ meningiomas are higher than that of WHO grade Ⅰ meningiomas.WHO grade Ⅱ and Ⅲ meningiomas are more common displaying heterogeneous intensity,and heterogeneous contrast enhancement comparing with WHO grade Ⅰ meningiomas.The incidences of partial or complete disappearance of the peritumoral band of WHO grade Ⅱ and Ⅲ meningiomas increase dramatically,while the rates of dural tail of WHO grade Ⅱ and Ⅲ meningiomas decrease slightly.Intratumoral cysts relate to higher occurrence of WHO grade Ⅱ and Ⅲ meningiomas,while peritumoral cysts were independent of it.There are no significant differences about peritumoral edema amoung WHO grade Ⅰ,Ⅱ and Ⅲ meningiomas.更多还原