Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.
Department of Neurosurgery, Sendai Medical Center, Sendai, Miyagi, Japan.
Neurol Med Chir (Tokyo). 2021 Mar 15;61(3):228-235. doi: 10.2176/nmc.oa.2020-0131. Epub 2021 Jan 28.
Few studies have reviewed the roles of perfusion magnetic resonance (MR) imaging in the histopathological examination of meningiomas. We analyzed the relationships between radiological findings on perfusion MR imaging and pathological characteristics such as origin of the tumor, mitotic activity, pathological subtype, and perifocal edema formation. The subjects were 21 surgical cases of meningioma preoperatively evaluated by perfusion MR imaging. A region of interest (ROI) was set inside of the tumor, and perifocal edema of the same size, cerebral blood volume (CBV), and cerebral blood flow (CBF) on perfusion MR and diffusion-weighted (DW) imaging were analyzed. These radiological data were evaluated in comparison with histopathological characteristics. On perfusion MR imaging, the average ratio of CBV against the contralateral side was 6.43 (1.13-20.0) and that of CBF was 7.73 (1.34-11.3). There was no significant relationship with perfusion MR imaging data, tumor volume, or perifocal edema volume. However, the large peritumoral edema group often had a higher CBV and CBF than the non-large peritumoral edema group. The skull base group had a significantly higher CBV and lower signal intensity on DW images than the non-skull base group. Signal intensity on DW images was higher in grade II or III than in grade I. Perfusion MR imaging data revealed that the higher ratio of peritumoral edema against tumor size was associated with higher blood flow and blood volume under intratumoral circulatory conditions, and that skull base meningioma had a higher blood volume than non-skull base meningioma.
很少有研究综述过磁共振灌注成像（MR）在脑膜瘤组织病理学检查中的作用。我们分析了磁共振灌注成像的影像学发现与肿瘤起源、有丝分裂活性、病理亚型和瘤周水肿形成等病理特征之间的关系。本研究共纳入 21 例术前接受磁共振灌注成像评估的脑膜瘤患者。在肿瘤内部设置感兴趣区（ROI），分析磁共振灌注成像和弥散加权成像上瘤周水肿的脑血容量（CBV）和脑血流量（CBF）。将这些影像学数据与组织病理学特征进行比较。磁共振灌注成像上，CBV 与对侧侧的平均比值为 6.43（1.13-20.0），CBF 为 7.73（1.34-11.3）。这些影像学数据与肿瘤体积或瘤周水肿体积无显著相关性。然而，大瘤周水肿组的 CBV 和 CBF 往往高于小瘤周水肿组。颅底组的 CBV 高于非颅底组，DW 图像上的信号强度较低。Ⅱ级或Ⅲ级的信号强度高于Ⅰ级。磁共振灌注成像数据显示，瘤周水肿与肿瘤大小的比值越高，肿瘤内循环条件下的血流量和血容量越高，颅底脑膜瘤的血容量高于非颅底脑膜瘤。
