弥散张量成像在脑膜瘤亚型鉴别中的作用。
Role of diffusion tensor imaging in differentiating subtypes of meningiomas.
机构信息
Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical sciences and Technology, Trivandrum 695011, India.
出版信息
J Neuroradiol. 2010 Dec;37(5):277-83. doi: 10.1016/j.neurad.2010.03.001. Epub 2010 Apr 9.
PURPOSE
Meningiomas are the most common extraaxial intracranial type of tumor, and their management and prognosis depend on their grade and histology. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are two new imaging techniques that have proved helpful in elucidating the microarchitecture of brain tumors. The aim of the present study was to assess the role of diffusion and diffusion tensor metrics in the identification and classification of meningioma grades and subtypes.
METHODS AND MATERIALS
A total of 21 consecutive patients with meningioma were included in this retrospective study, of whom 16 had benign meningiomas (three fibroblastic, 11 transitional/mixed, two meningothelial) and five had atypical meningiomas. Tumor mean diffusivity (Dav), fractional anisotropy (FA), linear anisotropy (CL), planar anisotropy (CP), spherical anisotropy (CS) and eigenvalues (e1, e2, e3) were measured in all cases, and differences in diffusion tensor metrics between atypical, fibroblastic and other benign (transitional, meningothelial) meningiomas were statistically analyzed using the Mann-Whitney test.
RESULTS
No statistically significant differences were found among the mean Dav values for atypical, fibroblastic and other benign meningiomas. Both atypical and fibroblastic meningiomas showed significantly higher mean FA values and lower mean CS values compared with other meningiomas (P<0.01), but no statistically significant difference in these values between each other. Atypical meningiomas showed higher CL values compared with fibroblastic and other benign meningiomas but, again, the difference was not statistically significant. Both atypical and fibroblastic meningiomas showed statistically significantly higher CP values and lower e3 values compared with transitional meningiomas (P<0.01).
CONCLUSION
These results suggest that diffusion tensor metrics may be helpful in the differentiation of atypical, fibroblastic and other benign meningiomas.
目的
脑膜瘤是最常见的颅内外生型肿瘤，其治疗和预后取决于其分级和组织学。弥散加权成像（DWI）和弥散张量成像（DTI）是两种新的成像技术，已被证明有助于阐明脑肿瘤的微观结构。本研究旨在评估扩散和扩散张量指标在识别和分类脑膜瘤分级和亚型中的作用。
方法和材料
本回顾性研究共纳入 21 例连续脑膜瘤患者，其中 16 例为良性脑膜瘤（3 例纤维型，11 例过渡型/混合性，2 例脑膜上皮型），5 例为非典型脑膜瘤。在所有病例中测量肿瘤平均弥散系数（Dav）、各向异性分数（FA）、线性各向异性（CL）、平面各向异性（CP）、球形各向异性（CS）和特征值（e1、e2、e3），并使用 Mann-Whitney 检验对非典型、纤维型和其他良性（过渡型、脑膜上皮型）脑膜瘤之间的弥散张量指标差异进行统计学分析。
结果
非典型、纤维型和其他良性脑膜瘤的平均 Dav 值无统计学差异。与其他脑膜瘤相比，非典型和纤维型脑膜瘤的平均 FA 值更高，平均 CS 值更低（P<0.01），但彼此之间无统计学差异。与纤维型和其他良性脑膜瘤相比，非典型脑膜瘤的 CL 值更高，但差异无统计学意义。与过渡型脑膜瘤相比，非典型和纤维型脑膜瘤的 CP 值更高，e3 值更低（P<0.01）。
结论
这些结果表明，扩散张量指标可能有助于区分非典型、纤维型和其他良性脑膜瘤。
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