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WHO 分级 I 型脑膜瘤亚型:MRI 特征与病理分析。

WHO grade I meningioma subtypes: MRI features and pathological analysis.

机构信息

Department of Radiology, Weifang People's Hospital, Weifang, 261000, China.

Department of Pathology, Weifang People's Hospital, Weifang, 261000, China.

出版信息

Life Sci. 2018 Nov 15;213:50-56. doi: 10.1016/j.lfs.2018.08.061. Epub 2018 Aug 25.

DOI:10.1016/j.lfs.2018.08.061
PMID:30153449
Abstract

AIMS

WHO grade I meningiomas include several subtypes that differ in terms of surgical planning and prognosis. We aim to analyze the relationship between magnetic resonance imaging (MRI) features and pathological parameters for each WHO grade I meningioma subtype to improve diagnostic value.

MATERIALS AND METHODS

Patients with WHO grade I meningiomas underwent pathology pathological examination and surgery at our hospital. MRI findings included signal intensity on T1WI and T2WI and, the enhancement degree in contrast-enhanced, and the degree of peritumoral edema in patients were reviewed. H-MRS was performed for the different meningioma subtypes. The correlation between MRI features and pathology was determined using a Kruskal-Wallis H test (P < 0.05).

KEY FINDINGS

Angiomatous meningiomas mainly showed a low T1WI signal, a high T2WI signal, a high occurrence rate of peritumoral edema, mainly with moderate or severe peritumoral edema, and homogeneous enhancement. Meningothelial meningiomas mainly showed T1WI and T2WI iso-intense signals, mainly moderate or severe peritumoral edema, and moderate enhancement. Mixed, fibroblastic, and psammomatous meningiomas showed mixed signals, much overlap of the T1WI and T2WI signals, mainly mild or moderate peritumoral edema, and mild or moderate enhancement that could be inhomogeneous. A significant difference was noted in apparent diffusion coefficient (ADC) values and in some H-MRS indicators among different meningioma subtypes.

SIGNIFICANCE

Angiomatous meningiomas were the most easily identified subtype, followed by meningothelial meningiomas. No obvious difference was observed among the mixed, fibroblastic, and psammomatous meningiomas, but differences were observed between angiomatous and meningothelial meningiomas.

摘要

目的

世界卫生组织(WHO)一级脑膜瘤包括几种在手术规划和预后方面存在差异的亚型。我们旨在分析每种 WHO 一级脑膜瘤亚型的磁共振成像(MRI)特征与病理参数之间的关系,以提高诊断价值。

材料与方法

在我院接受手术治疗并经病理检查证实为 WHO 一级脑膜瘤的患者,回顾性分析其 MRI 表现,包括 T1WI 和 T2WI 信号强度、增强程度及瘤周水肿程度,对不同脑膜瘤亚型进行氢质子磁共振波谱(H-MRS)分析。采用 Kruskal-Wallis H 检验(P<0.05)分析 MRI 特征与病理参数的相关性。

主要发现

血管型脑膜瘤主要表现为 T1WI 低信号、T2WI 高信号,瘤周水肿发生率高,以中重度瘤周水肿为主,呈均匀强化;内皮型脑膜瘤主要表现为 T1WI 和 T2WI 等信号,以中重度瘤周水肿为主,呈中度或明显强化;混合型、纤维型和砂粒体型脑膜瘤呈混杂信号,T1WI 和 T2WI 信号重叠较多,以轻中度瘤周水肿为主,呈轻中度强化,可呈不均匀强化。不同脑膜瘤亚型间表观弥散系数(ADC)值及部分 H-MRS 指标存在明显差异。

意义

血管型脑膜瘤最容易识别,其次是内皮型脑膜瘤;混合型、纤维型和砂粒体型脑膜瘤之间无明显差异,但血管型脑膜瘤与内皮型脑膜瘤之间存在差异。

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