Hutzelmann A, Palmié S, Buhl R, Freund M, Heller M
Department of Radiology, Christian Albrechts University, Kiel, Germany.
Eur Radiol. 1998;8(5):746-8. doi: 10.1007/s003300050466.
In intracranial meningiomas a flat, contrast-enhancing, dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA-enhanced MR images. We wished to evaluate whether there is a correlation between MR images and meningeal invasion of intracranial meningiomas. The study included 54 patients with intracranial meningioma and the meningeal sign. MR studies included T2-weighted and gadolinium-DTPA-enhanced T1-weighted images in axial, coronal, and sagittal planes. Histopathologic examinations were done on the meningiomas adjacent to the dura mater. The meningeal sign on MRI was observed from 2 up to 35 mm from the main tumor mass in 31 (57 %) of the 54 patients. In 20 of these 31 the histopathologic examination showed tumor invasion, while 11 patients had no tumor invasion but tissue proliferation, hypervascularity, and vascular dilatation. Seven of the 23 meningiomas without the meningeal sign had histologically proven infiltration of the adjacent dura. MR imaging is not able to determine definitive whether or not there is dural infiltration of the meningiomas. In conclusion, resection of the tumor with a wide margin is necessary to achieve complete excision of meningioma and to avoid recurrence.
在颅内脑膜瘤中，钆喷酸葡胺增强磁共振成像（MR）偶尔可观察到肿瘤旁扁平的、强化的硬脑膜结构。我们希望评估MR图像与颅内脑膜瘤脑膜侵犯之间是否存在相关性。该研究纳入了54例有颅内脑膜瘤及脑膜征的患者。MR检查包括轴位、冠状位和矢状位的T2加权像及钆喷酸葡胺增强T1加权像。对硬脑膜附近的脑膜瘤进行组织病理学检查。54例患者中，31例（57%）在距主要肿瘤块2至35毫米处观察到MRI脑膜征。在这31例中的20例，组织病理学检查显示肿瘤侵犯，而11例患者无肿瘤侵犯，但有组织增生、血管增多和血管扩张。23例无脑膜征的脑膜瘤中，7例经组织学证实有邻近硬脑膜浸润。MR成像无法明确判断脑膜瘤是否存在硬脑膜浸润。总之，为实现脑膜瘤的完整切除并避免复发，进行肿瘤的广泛切除是必要的。
