Elster A D, Challa V R, Gilbert T H, Richardson D N, Contento J C
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Radiology. 1989 Mar;170(3 Pt 1):857-62. doi: 10.1148/radiology.170.3.2916043.
The magnetic resonance (MR) appearances of 40 biopsy-proved meningiomas were blindly evaluated and correlated with their predominant histologic pattern--fibroblastic, transitional, syncytial, angioblastic, or mixed. T1-weighted images were not particularly useful in discriminating pathologic subtype, because most tumors were isointense with or hypointense to cortex regardless of histologic type. Signal intensity and features on T2-weighted images strongly correlated with histopathologic findings in over 75% of cases, however. Meningiomas markedly hypointense to cortex on T2-weighted images (seven of 40 cases) were composed predominantly of fibroblastic or transitional elements, while markedly hyperintense meningiomas (14 of 40 cases) demonstrated predominance of syncytial or angioblastic elements. Consideration of secondary features visible at MR imaging (degree of edema, cyst formation, presence of calcium aggregates) led to a more specific histologic prediction in over half of the remaining isointense tumors. The varied MR appearance of meningiomas has a clear histologic basis, and crude prediction of pathologic subtype is possible in over three-fourths of cases.
对40例经活检证实的脑膜瘤的磁共振（MR）表现进行了盲法评估，并将其与主要组织学模式——纤维母细胞型、过渡型、合体细胞型、血管母细胞型或混合型进行关联。T1加权图像在鉴别病理亚型方面并非特别有用，因为无论组织学类型如何，大多数肿瘤与皮质呈等信号或低信号。然而，在超过75%的病例中，T2加权图像上的信号强度和特征与组织病理学结果密切相关。在T2加权图像上明显低于皮质信号的脑膜瘤（40例中的7例）主要由纤维母细胞或过渡型成分组成，而明显高信号的脑膜瘤（40例中的14例）则以合体细胞或血管母细胞型成分占主导。考虑到MR成像中可见的次要特征（水肿程度、囊肿形成、钙聚集物的存在），在其余等信号肿瘤的一半以上病例中可得出更具特异性的组织学预测。脑膜瘤多样的MR表现有明确的组织学基础，在超过四分之三的病例中可以对病理亚型进行粗略预测。
