Wasenko J J, Hochhauser L, Stopa E G, Winfield J A
Department of Radiology, State University of New York Health Science Center, Syracuse.
AJNR Am J Neuroradiol. 1994 Nov;15(10):1959-65.
To describe the MR appearance of cystic meningiomas, and to correlate the MR appearance with the surgical and neuropathologic findings.
Eight patients with cysts associated with meningiomas were studied on a 1.5-T MR system. Unenhanced sagittal T1- and axial T2-weighted images were obtained in all patients. Axial and coronal gadopentetate dimeglumine-enhanced T1-weighted spin-echo images were obtained in seven patients. Additional sagittal T1-weighted spin-echo contrast-enhanced images were obtained in four patients.
The cystic components were intratumoral and eccentric in two cases, intraparenchymal in one case, and extraparenchymal (trapped cerebrospinal fluid) in five cases. Cyst wall enhancement was present in two of seven cases performed with intravenous gadopentetate dimeglumine. There was no correlation between cyst signal intensity and cyst content. A preoperative diagnosis of cystic meningioma was possible in all eight cases.
MR demonstrates the extradural location of the tumor and its cystic component, correlates well with the surgical presentation and the neuropathologic results, and allows the preoperative diagnosis of cystic meningioma based on the MR findings. Division into three types of cysts aids the neurosurgeon, who must decide whether total resection is feasible. To obtain total resection and reduce the risk of recurrence with an intratumoral cyst, the surgeon must ensure that the plane of resection is in fact between the thin enhancing membrane of the tumor cyst and the adjacent arachnoid. In cases in which the cyst is trapped cerebrospinal fluid or intraparenchymal in location, the cyst wall adjacent to or within the brain parenchyma is not included in the resection.
描述囊性脑膜瘤的磁共振成像（MR）表现，并将MR表现与手术及神经病理学结果相关联。
对8例伴有脑膜瘤囊肿的患者采用1.5-T MR系统进行研究。所有患者均获得矢状位T1加权像及轴位T2加权像。7例患者获得轴位及冠状位钆喷酸葡胺增强T1加权自旋回波像。4例患者额外获得矢状位T1加权自旋回波增强对比像。
2例囊肿成分位于肿瘤内且偏心，1例位于脑实质内，5例为脑实质外（脑脊液包裹）。7例行静脉钆喷酸葡胺增强检查的患者中，2例囊肿壁有强化。囊肿信号强度与囊肿内容物之间无相关性。8例患者术前均有可能诊断为囊性脑膜瘤。
MR可显示肿瘤及其囊性成分的硬膜外位置，与手术表现及神经病理学结果相关性良好，并可根据MR表现进行囊性脑膜瘤的术前诊断。将囊肿分为三种类型有助于神经外科医生决定是否可行全切除。对于肿瘤内囊肿，为实现全切除并降低复发风险，外科医生必须确保切除平面实际上位于肿瘤囊肿的薄强化膜与相邻蛛网膜之间。对于囊肿为脑脊液包裹或位于脑实质内的情况，切除时不包括与脑实质相邻或位于脑实质内的囊肿壁。
