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脑膜瘤的影像学与组织病理学类型的相关性:一项队列研究。

Correlation between Radiological Images and Histopathological Type of Meningioma: A Cohort Study.

机构信息

Department of Neurosurgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

Department of Neurosurgery, Wahidin Sudirohusodo Hospital, Makassar, Indonesia.

出版信息

Ethiop J Health Sci. 2022 May;32(3):597-604. doi: 10.4314/ejhs.v32i3.16.

Abstract

BACKGROUND

Histologically affirmed meningiomas represent 37.6% of all essential central nervous system tumors and half of all types of critical central nervous system tumors. This study compares computed tomography (CT) scans of the head with histological findings to establish the characteristics of different types of meningiomas observed in eastern Indonesia.

METHODS

This prospective study evaluated 224 patients by examining the correlation between histological and CT data collected from January to December 2020 at Wahidin Sudirohusodo Hospital, Makassar, Indonesia. We assessed data including the location of pre- and post-contrast CT scans, number of tumors, margin, density, contrast enhancement, bony reaction, calcification, and perifocal edema. Patients underwent biopsies followed by an examination of the anatomical pathology tissue.

RESULTS

The female-to-male ratio of participants was 4.2 to 1, and the highest incidence was observed in participants of both genders aged 40-60 years. The most common meningioma subtype was meningothelial, while the most commonly observed locations involved the convexity and sphenoid regions. Most meningiomas had well-defined margins on CT imaging: 54.5% of patients exhibited isodense lesions on pre-contrast scans, and 64.7% exhibited high-contrast enhancement. Bone destruction developed in 4.1% of patients, while hyperostosis was observed in 17.4%, and calcification was present in 10.3% of the participants. Edema was identified in 65.2% of cases, of which moderate edema was the most common manifestation.

CONCLUSION

Meningioma should be highly suspected in female patients aged 40-60 with isodense lesions on pre-contrast CT scans and high-contrast enhancement on post-contrast CT scans. Meningiomas were primarily classified as convexity meningiomas with well-defined margins. The presence of hyperostosis, calcification, and brain edema supported the meningioma diagnosis.

摘要

背景

经组织学证实的脑膜瘤占所有中枢神经系统肿瘤的 37.6%,占所有中枢神经系统肿瘤的一半。本研究通过比较头部 CT 扫描与组织学发现,来确定在印度尼西亚东部观察到的不同类型脑膜瘤的特征。

方法

本前瞻性研究评估了 224 名患者,通过检查 2020 年 1 月至 12 月在印度尼西亚望加锡 Wahidin Sudirohusodo 医院收集的组织学和 CT 数据之间的相关性。我们评估了包括 CT 扫描的位置、肿瘤数量、边缘、密度、对比增强、骨反应、钙化和周围水肿等数据。患者接受了活检,随后对解剖病理组织进行了检查。

结果

参与者的男女比例为 4.2:1,发病率最高的是 40-60 岁的男女两性。最常见的脑膜瘤亚型是脑膜内皮型,最常见的观察部位是凸面和蝶骨区。大多数脑膜瘤在 CT 成像上具有清晰的边缘:54.5%的患者在增强前 CT 扫描上显示等密度病变,64.7%的患者显示高对比度增强。4.1%的患者发生骨破坏,17.4%的患者出现骨质增生,10.3%的患者出现钙化。65.2%的患者出现水肿,其中中度水肿最常见。

结论

对于增强前 CT 扫描显示等密度病变和增强后 CT 扫描显示高对比度增强的 40-60 岁女性患者,应高度怀疑脑膜瘤。脑膜瘤主要分类为边界清楚的凸面脑膜瘤。骨质增生、钙化和脑水肿的存在支持脑膜瘤的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9816/9214728/1ce355fe41a0/EJHS3203-0597Fig1.jpg

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