Zhang Rui, Shen Yu, Bai Yan, Zhang Xianchang, Wei Wei, Lin Ruijuan, Feng Qin, Wang Mengke, Zhang Menghuan, Nittka Mathias, Koerzdoerfer Gregor, Wang Meiyun
Department of Medical Imaging, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, China.
Henan Key Laboratory of Neurological Imaging, Zhengzhou, China.
Quant Imaging Med Surg. 2021 Apr;11(4):1447-1457. doi: 10.21037/qims-20-732.
The choice of surgical treatment for meningiomas is affected by the subtype and clinical characteristics. Therefore, an accurate preoperative diagnosis is essential. Current magnetic resonance imaging (MRI) technology is unable to distinguish between meningioma subtypes. In the present study, we compared and evaluated the utility of conventional MRI, magnetic resonance fingerprinting (MRF), and diffusion-weighted imaging (DWI) in differentiating World Health Organization grade I transitional and fibrous meningiomas from meningothelial meningiomas.
Forty-six patients with pathologically confirmed meningiomas (15 meningothelial, 18 transitional, and 13 fibrous) were enrolled in the present study. All patients underwent conventional MRI, MRF, and DWI scans before surgery using a 3T scanner. The Jonckheere-Terpstra test was used to analyze differences in the signal and enhancement characteristics of the three groups from T-weighted imaging (T1WI) and T-weighted imaging (T2WI). To investigate the difference in quantitative T1 and T2 values derived from MRF and apparent diffusion coefficient (ADC) values between the three groups using the Kruskal-Wallis test, regions of interest (ROIs) were manually drawn on the parenchymal portion of the tumors; P<0.017 was considered statistically significant after Bonferroni correction for multiple comparison. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performances of the different parameters.
Meningothelial meningiomas had significantly higher T1 and T2 values than transitional and fibrous meningiomas (all P<0.017). ROC analysis results revealed that the combination of T1 and T2 values had the largest area under the curve (AUC). The AUC for the combination of T1 and T2 values was 0.826 between meningothelial and transitional meningiomas, and the AUC for the combination of T1 and T2 values between meningothelial and fibrous meningiomas was 0.903. No significant differences were found in the T1 and T2 values between transitional and fibrous meningiomas. There were also no statistically significant differences in the conventional MRI (including T1WI, T2WI, and contrast-enhanced T1WI) and ADC values between the three meningioma subtypes (all P>0.05).
MRF may provide more quantitative information than either conventional MRI or DWI for differentiating transitional and fibrous meningiomas from meningothelial meningiomas. T1 and T2 values derived from MRF may distinguish transitional and fibrous meningiomas from meningothelial meningiomas, and the combination of T1 and T2 values provides the highest diagnostic efficacy.
脑膜瘤的手术治疗选择受亚型和临床特征影响。因此，准确的术前诊断至关重要。目前的磁共振成像（MRI）技术无法区分脑膜瘤亚型。在本研究中，我们比较并评估了传统MRI、磁共振指纹成像（MRF）和扩散加权成像（DWI）在区分世界卫生组织I级过渡型和纤维型脑膜瘤与脑膜皮型脑膜瘤方面的效用。
本研究纳入46例经病理证实的脑膜瘤患者（15例脑膜皮型、18例过渡型和13例纤维型）。所有患者在手术前使用3T扫描仪进行传统MRI、MRF和DWI扫描。采用Jonckheere-Terpstra检验分析三组在T加权成像（T1WI）和T加权成像（T2WI）上信号和强化特征的差异。为了使用Kruskal-Wallis检验研究三组之间从MRF得出的定量T1和T2值以及表观扩散系数（ADC）值的差异，在肿瘤实质部分手动绘制感兴趣区（ROI）；经Bonferroni多重比较校正后，P<0.017被认为具有统计学意义。采用受试者操作特征（ROC）曲线评估不同参数的诊断性能。
脑膜皮型脑膜瘤的T1和T2值显著高于过渡型和纤维型脑膜瘤（所有P<0.017）。ROC分析结果显示，T1和T2值的组合曲线下面积（AUC）最大。脑膜皮型和过渡型脑膜瘤之间T1和T2值组合的AUC为0.826，脑膜皮型和纤维型脑膜瘤之间T1和T2值组合的AUC为0.903。过渡型和纤维型脑膜瘤之间的T1和T2值无显著差异。三种脑膜瘤亚型在传统MRI（包括T1WI、T2WI和对比增强T1WI）和ADC值方面也无统计学显著差异（所有P > 0.05）。
与传统MRI或DWI相比，MRF在区分过渡型和纤维型脑膜瘤与脑膜皮型脑膜瘤方面可能提供更多定量信息。从MRF得出的T1和T2值可区分过渡型和纤维型脑膜瘤与脑膜皮型脑膜瘤，且T1和T2值的组合具有最高的诊断效能。
