目的 应用磁共振弥散张量成像(DTI)量化比较不同类型脑膜瘤的侵袭性.方法 脑膜瘤患者22例,其中良性脑膜瘤16例,非典型脑膜瘤6例;建立脑膜瘤的不同侵袭性病理标准,与脑膜瘤的病理类型进行相关分析;利用磁共振成像(MRI)和DTI,确定与肿瘤相关的5个兴趣区(肿瘤实体区、瘤周水肿区、水肿外区、相对正常白质区和对侧白质区),并测量其各自的分量各向异性(FA)值,比较分析各类型脑膜瘤在不同兴趣区的FA值.结果 脑膜瘤的病理类型与其脑浸润程度差异有统计学意义,但与脑膜浸润程度和颅骨浸润程度差异无统计学意义.DTI分析:在瘤周水肿区,有脑浸润脑膜瘤的FA值较无脑浸润的脑膜瘤低,差异有统计学意义(P＜0.05);肿瘤实体区,有脑膜浸润患者FA值较无脑膜浸润患者低,差异有统计学意义(P＜0.05);其余兴趣区和其他浸润方式比较,差异均无统计学意义(P＞0.05).结论 非典型脑膜瘤的脑浸润能力强于良性脑膜瘤,但其脑膜浸程度润程度和颅骨浸润能力与良性脑膜瘤相比差异不明显.%Objective To observe invasiveness of various meningiomas by diffuse tensor imaging(DTI).Methods Twenty-two patients with histologically confirmed meningiomas,including 16 benign meningiomas and 6 atypical ones,were included in this study.Patients were classified into different subgroups according to the established standards of invasion.Correlative analysis was done between vafioius invasive potential and pathological diagnosis.Comparing the conventional MRI and DTI sequences,five regions of interest(ROI)--tumor,peritumoral edema region,outer region of edema,white matter region and contralateral white matter region-were drawn from tumor and white matter at various distance from tumor.FA values were calculated in every region.Comparative analysis of FA in different regions was done.Results Significant correlation between degree of brain invasion and pathological type of meningiomas was found in this study.But neither dura invasion nor skull invasion was correlated with histological diagnosis.FA values of peritumoral edema region of meningiomas with brain invasion were significantly different from those of meningiomas without brain invasion.In tumor area,FA values of brain invasive group were significantly less than those of non-invasion group.No significant difference of all parameters was found among other groups.Conclusion According to imaging quantitive analysis,brain invasiveness of atypical meningiomas is stronger than that of benign meningiomas.However,differences of dura invasion and skull invasion are not significant between these two groups.
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