Cabada T, Caballero M C, Insausti I, Alvarez de Eulate N, Bacaicoa C, Zazpe I, Tuñón T
Servicio de Radiología, Hospital de Navarra, Pamplona, Spain.
Radiologia. 2009 Jul-Aug;51(4):411-9. doi: 10.1016/j.rx.2009.01.017. Epub 2009 Jun 23.
To study the behavior of meningiomas in diffusion-weighted sequences and the correlation of these findings with the histological findings.
We prospectively included all patients operated on for meningiomas at our hospital during two years. We studied 30 meningiomas in 28 patients aged 31 to 85 years old. All patients underwent MRI prior to surgery, including diffusion-weighted sequences, in a 1.5 T scanner. We evaluated the signal intensity in T2-weighted images, diffusion-weighted images (b=1,000), and apparent diffusion coefficient (ADC) maps within the tumor and in the parietal white matter as a reference. In the histological study, cellularity, proliferation index, histological grade, and cerebral invasion were evaluated.
Of the 30 meningiomas, 22 were World Health Organization (WHO) grade I and 8 were atypical or WHO grade II. The overall mean value of the ADC was 89.19+/-13.95x10(-3) mm2/s; the mean ADC value was 82+/-13.69x10(-3) mm2/s in the atypical group and 92.21+/-13.21x10(-3) mm2/s in the typical group. No statistically significant differences were found between the 2 groups. Two subtypes of typical meningiomas, secretory and angiomatous meningiomas, had the highest values in the ADC maps. In the histological analysis, there was a significant association between tumor cellularity and the signal in the ADC map.
Meningiomas show moderately restricted diffusion. The signal on the ADC map is associated with tumor cellularity but we have not demonstrated its usefulness for predicting the histological grade.
研究脑膜瘤在扩散加权序列中的表现以及这些表现与组织学结果的相关性。
我们前瞻性纳入了我院两年内接受脑膜瘤手术的所有患者。我们研究了28例年龄在31至85岁之间患者的30个脑膜瘤。所有患者在手术前均接受了MRI检查,包括在1.5T扫描仪上进行扩散加权序列扫描。我们评估了肿瘤内及顶叶白质(作为参照)在T2加权图像、扩散加权图像(b = 1000)及表观扩散系数(ADC)图中的信号强度。在组织学研究中,评估了细胞密度、增殖指数、组织学分级及脑侵袭情况。
30个脑膜瘤中,22个为世界卫生组织(WHO)I级,8个为非典型或WHO II级。ADC的总体平均值为89.19±13.95×10⁻³mm²/s;非典型组的平均ADC值为82±13.69×10⁻³mm²/s,典型组为92.21±13.21×10⁻³mm²/s。两组之间未发现统计学上的显著差异。典型脑膜瘤的两种亚型,即分泌型和血管瘤型脑膜瘤,在ADC图中的值最高。在组织学分析中,肿瘤细胞密度与ADC图中的信号之间存在显著关联。
脑膜瘤表现出中等程度的扩散受限。ADC图上的信号与肿瘤细胞密度相关,但我们尚未证明其对预测组织学分级的有用性。