Zee C S, Chen T, Hinton D R, Tan M, Segall H D, Apuzzo M L
Department of Radiology, University of Southern California School of Medicine, Los Angeles, USA.
Neurosurgery. 1995 Mar;36(3):482-8. doi: 10.1227/00006123-199503000-00006.
Our purpose was to document the incidence and imaging features of cystic meningiomas, to correlate the imaging features of cystic meningiomas with the histopathological findings, and to analyze the surgical implications of the imaging features of cystic meningiomas. The imaging studies, clinical histories, operative findings, and histopathological findings of a total of 128 patients with meningiomas were reviewed retrospectively. The 15 cystic meningiomas in our series could be morphologically divided into three major types: cystic areas contained wholly within the tumor (6 meningiomas), cystic areas at the periphery of, but wholly within, the margins of the tumor (5 meningiomas), and cystic areas peripheral to the tumor, lying on the adjacent brain (4 meningiomas). A majority of cystic meningiomas were histopathologically diagnosed to be meningothelial (8 of 15 meningiomas). Cellular atypia was seen in many patients. Meningiomas may simulate astrocytomas or metastatic lesions on imaging studies. Magnetic resonance imaging had a diagnostic accuracy of 80% (12 of 15 patients), which was significantly better than the computed tomography diagnostic accuracy of 50% or less. Magnetic resonance imaging with contrast enhancement could distinguish Type 2 (cyst wall containing tumor cells) and Type 3 (cyst wall containing gliotic tissue without tumor invasion) cystic meningiomas. Cyst wall enhancement was seen in Type 2, but not in Type 3, cystic meningiomas. Cystic meningiomas represented approximately 10% of all meningiomas in our series. Histiologically, they were usually relatively aggressive, which probably partly explains why cystic changes may be secondary to tumor necrosis or hemorrhage. Recognition of the diagnostic features of cystic meningiomas is important, because they may mimic metastatic neoplasms or primary gliomas.(ABSTRACT TRUNCATED AT 250 WORDS)
我们的目的是记录囊性脑膜瘤的发病率和影像学特征，将囊性脑膜瘤的影像学特征与组织病理学结果相关联，并分析囊性脑膜瘤影像学特征的手术意义。回顾性分析了128例脑膜瘤患者的影像学检查、临床病史、手术发现和组织病理学结果。我们系列中的15例囊性脑膜瘤在形态上可分为三大类型：囊肿区域完全包含在肿瘤内（6例脑膜瘤）、囊肿区域位于肿瘤周边但完全在肿瘤边缘内（5例脑膜瘤）、囊肿区域位于肿瘤外周并紧邻脑实质（4例脑膜瘤）。大多数囊性脑膜瘤在组织病理学上被诊断为脑膜内皮型（15例脑膜瘤中的8例）。许多患者可见细胞异型性。脑膜瘤在影像学检查中可能类似星形细胞瘤或转移瘤。磁共振成像的诊断准确率为80%（15例患者中的12例），显著优于计算机断层扫描50%或更低的诊断准确率。增强磁共振成像可区分2型（囊肿壁含肿瘤细胞）和3型（囊肿壁含胶质化组织无肿瘤浸润）囊性脑膜瘤。2型囊性脑膜瘤可见囊肿壁强化，而3型则无。在我们的系列中，囊性脑膜瘤约占所有脑膜瘤的10%。从组织学上看，它们通常具有相对侵袭性，这可能部分解释了为什么囊性改变可能继发于肿瘤坏死或出血。认识囊性脑膜瘤的诊断特征很重要，因为它们可能酷似转移性肿瘤或原发性胶质瘤。（摘要截短于250字）
