Liu Meng, Liu Yuguang, Li Xingang, Zhu Shugan, Wu Chengyuan
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China.
J Clin Neurosci. 2007 Sep;14(9):856-9. doi: 10.1016/j.jocn.2006.06.003. Epub 2007 Jun 26.
To study the clinical characteristics of cystic meningiomas, we analyzed retrospectively 21 patients with cystic meningiomas and reviewed the literature with regard to clinical presentation, imaging features, preoperative diagnosis, surgical findings, and histopathological results. The cysts were classified into intratumoral and peritumoral cysts based on their relationship to the tumor, and also according to the classification method described by Nauta. For the 21 patients in our group, there were seven peritumoral cysts and 14 intratumoral cysts. Various pathophysiological mechanisms contribute to the formation of cystic meningiomas. The diagnosis of cystic meningiomas based on CT scan can be problematic, and differentiation from glioma or metastasis may be difficult. MRI scans show low signal intensity areas within the mass on T1-weighted images and high signal intensity areas on T2-weighted images, and the solid parts of tumors are contrast-enhanced after gadolinium administration. MRI with gadolinium enhancement dramatically increases the diagnostic accuracy for cystic meningiomas and provides critical information for their surgical care. Total surgical resection of cystic meningioma is ideal, but special attention should be paid to the cyst walls.
为研究囊性脑膜瘤的临床特征，我们回顾性分析了21例囊性脑膜瘤患者，并就临床表现、影像学特征、术前诊断、手术所见及组织病理学结果对相关文献进行了综述。根据囊肿与肿瘤的关系，以及按照Nauta描述的分类方法，将囊肿分为瘤内囊肿和瘤周囊肿。在我们组的21例患者中，有7例瘤周囊肿和14例瘤内囊肿。多种病理生理机制促成了囊性脑膜瘤的形成。基于CT扫描诊断囊性脑膜瘤可能存在问题，且与胶质瘤或转移瘤的鉴别可能困难。MRI扫描显示，在T1加权图像上肿块内为低信号强度区，在T2加权图像上为高信号强度区，肿瘤的实性部分在给予钆后有强化。钆增强MRI显著提高了囊性脑膜瘤的诊断准确性，并为其手术治疗提供关键信息。囊性脑膜瘤的全切除是理想的，但应特别注意囊肿壁。
