Mishra Atul, Thomas Bejoy, Kapilamoorthy T R
1 Armed Forces Medical College, Military Hospital (CTC), India.
2 Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India.
Neuroradiol J. 2017 Jun;30(3):253-258. doi: 10.1177/1971400916689804. Epub 2017 Jan 1.
Background and purpose Vestibular schwannomas and meningiomas of the cerebellopontine angle can be differentiated by the presence of foci of blooming on susceptibility weighted imaging. Materials and methods In this retrospective study, magnetic resonance imaging with susceptibility weighted imaging sequence in addition to other routine sequences was done in 73 patients. All the cases were studied for the presence of foci of blooming within the tumor on susceptibility weighted imaging. Histopathological examination confirmed the diagnosis in all cases. Results There were 59 patients in the vestibular schwannoma group and 14 in the meningioma group. Susceptibility weighted imaging showed presence of blooming (due to microhemorrhages) in all the cases of cerebellopontine angle schwannomas. In the meningioma group, 13 cases showed no blooming within the lesion; one case showed blooming which was confirmed to be due to calcification on computed tomography study. For the detection of foci of blooming and predicting histopathologic diagnosis of schwannoma pre-operatively, susceptibility weighted imaging showed a sensitivity of 100%, specificity of 92%, positive predictive value of 98.3%, and negative predictive value of 100%. The Fisher exact test showed a statistically significant difference in the differentiation of vestibular schwannoma from meningioma on the basis of detection of blooming on susceptibility weighted imaging ( p < 0.0001). Conclusion Susceptibility weighted imaging is a problem-solving tool in making accurate pre-operative differentiation of vestibular schwannoma from meningioma.
背景与目的 桥小脑角区的前庭神经鞘瘤和脑膜瘤可通过磁敏感加权成像上的 blooming 病灶来鉴别。材料与方法 在这项回顾性研究中，对 73 例患者进行了除其他常规序列外还包括磁敏感加权成像序列的磁共振成像检查。所有病例均研究了磁敏感加权成像上肿瘤内是否存在 blooming 病灶。所有病例均经组织病理学检查确诊。结果 前庭神经鞘瘤组有 59 例患者，脑膜瘤组有 14 例患者。磁敏感加权成像显示所有桥小脑角神经鞘瘤病例均存在 blooming（由于微出血）。在脑膜瘤组中，13 例病变内未显示 blooming；1 例显示 blooming，经计算机断层扫描研究证实为钙化所致。对于术前检测 blooming 病灶并预测神经鞘瘤的组织病理学诊断，磁敏感加权成像显示敏感性为 100%，特异性为 92%，阳性预测值为 98.3%，阴性预测值为 100%。Fisher 精确检验显示，基于磁敏感加权成像上 blooming 的检测，前庭神经鞘瘤与脑膜瘤的鉴别存在统计学显著差异（p < 0.0001）。结论 磁敏感加权成像是术前准确鉴别前庭神经鞘瘤与脑膜瘤的一种解决问题的工具。
