Sato M, Matsumoto M, Kodama N
Department of Neurosurgery, Fukushima Medical University School of Medicine.
Fukushima J Med Sci. 1998 Jun;44(1):1-11.
Meningeal enhancement (ME) using Gd-DTPA MRI was studied in 25 of 35 patients with meningiomas, and its clinical importance on associated MRI and histologic findings of ME was evaluated. ME extended 0.5-4.3 cm (mean: 1.5 cm) from the tumor attachment site, and was classified morphologically into two patterns: that extending with a gentle curve from the tumor attachment site to the dura, and that extending linearly. Tumor parenchyma was differentiated from ME based on time-dependent changes in signal intensity on Gd-DTPA MRI. Histologic examination was performed in tissue from regions of ME of 15 patients. Tissue corresponding to regions of ME consisted of two layers: an outer dura mater layer and an inner layer of hyperplasic loose fibrous tissue with dilated capillaries. Meningeal tumor cell clusters were observed in the fibrous tissue of 4 patients. These clusters were observed at a maximum distance of 1.4 cm from the tumor attachment site. It is thought that meningeal tumor cell clusters may represent a potential cause of local recurrence. Therefore, resection of the dura at least 2 cm from the tumor attachment site may be required to prevent local recurrence.
对35例脑膜瘤患者中的25例进行了钆喷酸葡胺磁共振成像（Gd-DTPA MRI）的脑膜强化（ME）研究，并评估了其在相关MRI及ME组织学表现方面的临床重要性。ME从肿瘤附着部位延伸0.5 - 4.3厘米（平均：1.5厘米），形态学上分为两种类型：一种是从肿瘤附着部位以平缓曲线延伸至硬脑膜，另一种是呈线性延伸。根据Gd-DTPA MRI上信号强度随时间的变化，肿瘤实质与ME得以区分。对15例患者ME区域的组织进行了组织学检查。与ME区域对应的组织由两层组成：外层硬脑膜层和内层增生的疏松纤维组织层，其中有扩张的毛细血管。在4例患者的纤维组织中观察到脑膜肿瘤细胞簇。这些簇在距肿瘤附着部位最远1.4厘米处被观察到。据认为，脑膜肿瘤细胞簇可能是局部复发的潜在原因。因此，可能需要从肿瘤附着部位至少切除2厘米的硬脑膜以预防局部复发。
