Panigrahi Mousam, Bodhey Narendra K, Pati Saroj K, Hussain Nighat, Sharma Anil K, Shukla Arvind K
Department of Radiodiagnosis, All India Institute of Medical Sciences, Raipur, India.
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Raipur, India.
SA J Radiol. 2022 Oct 26;26(1):2480. doi: 10.4102/sajr.v26i1.2480. eCollection 2022.
Meningiomas are the most prevalent of all intracranial tumours. Although they are mostly benign, about 20% of meningiomas are atypical or malignant. Knowledge of their histologic grade can be clinically useful while planning surgery.
To differentiate between various grades and subtypes of meningiomas with advanced MR parameters.
We assessed the advanced MR imaging characteristics of 27 histopathologically confirmed meningiomas on a 3T MRI, of which 23 were grade I meningiomas (2 fibroblastic, 9 meningothelial, 9 transitional, 3 unspecified) and 4 were grade II/III meningiomas (2 atypical, 1 papillary, 1 anaplastic). Analysis of the ADC, FA, λ1, λ2, λ3 and mean diffusivity was performed using standard post-processing software.
The mean size of atypical meningiomas (5.9 cm ± 0.7 cm) was significantly higher ( = 0.038, 95% confidence interval [CI]) than that of typical meningiomas (4.6 cm ± 1.6 cm) with a cut-off value of 6.05 cm (75% sensitivity and 87% specificity). The mean cerebral blood flow (CBF) (ASL) of atypical meningiomas (286.70 ± 8.06) was significantly higher ( = 0.0000141, 95% CI) than that of typical meningiomas (161.09 ± 87.04) with a cut-off value of 276.75 (66.7% sensitivity and 75% specificity). Among the typical meningiomas, transitional subtypes had the lowest ADC. High FA and planar coefficient (CP) values and low λ3 and spherical coefficient (CS) values were seen in fibroblastic meningiomas. Fibroblastic meningiomas also showed the lowest vascularity among typical meningiomas.
Tumour size and ASL perfusion are two parameters that could differentiate between typical and atypical meningiomas while ADC, FA, λ3, CP, CS, rCBF and rCBV may be helpful in distinguishing different subtypes of typical meningiomas.
脑膜瘤是所有颅内肿瘤中最常见的。尽管它们大多是良性的，但约20%的脑膜瘤是不典型的或恶性的。在规划手术时，了解其组织学分级在临床上可能有用。
利用先进的磁共振参数区分脑膜瘤的不同分级和亚型。
我们在3T磁共振成像上评估了27例经组织病理学证实的脑膜瘤的先进磁共振成像特征，其中23例为I级脑膜瘤（2例纤维母细胞型、9例脑膜皮型、9例过渡型、3例未明确型），4例为II/III级脑膜瘤（2例非典型性、1例乳头状、1例间变性）。使用标准后处理软件对表观扩散系数（ADC）、各向异性分数（FA）、λ1、λ2、λ3和平均扩散率进行分析。
非典型脑膜瘤的平均大小（5.9 cm±0.7 cm）显著高于典型脑膜瘤（4.6 cm±1.6 cm）（P = 0.038，95%置信区间[CI]），截断值为6.05 cm（敏感性75%，特异性87%）。非典型脑膜瘤的平均脑血流量（CBF）（动脉自旋标记法[ASL]）（286.70±8.06）显著高于典型脑膜瘤（161.09±87.04）（P = 0.0000141，95%CI），截断值为276.75（敏感性66.7%，特异性75%）。在典型脑膜瘤中，过渡型亚型的ADC最低。纤维母细胞型脑膜瘤表现出高FA值和平面系数（CP）值以及低λ3值和球形系数（CS）值。纤维母细胞型脑膜瘤在典型脑膜瘤中血管化程度也最低。
肿瘤大小和ASL灌注是区分典型和非典型脑膜瘤的两个参数，而ADC、FA、λ3、CP、CS、相对脑血流量（rCBF）和相对脑血容量（rCBV）可能有助于区分典型脑膜瘤的不同亚型。
