非典型性和间变性脑膜瘤的MR表现及病理对照

摘要

目的 探讨非典型性和间变性脑膜瘤的MR表现,并结合病理对照研究.方法 回顾性分析病理证实的非典型性脑膜瘤6例、间变性脑膜瘤5例的临床及影像学资料,11例均行MR平扫和增强扫描.结果 6例非典型性脑膜瘤2例发生于大脑半球凸面,1例发生于桥小脑角后部,2例发生于大脑镰旁,1例发生于上矢状窦旁.6例非典型性脑膜瘤MR平扫表现为等、长或稍长T1、等、稍长或长T2信号;增强扫描4例病灶均匀强化,1例表现为瘤体内点、条状强化,1例病灶强化欠均匀,内见钙化和小囊变.5例间变性脑膜瘤均发生于大脑半球凸面.5例间变性脑膜瘤MR平扫表现为不均匀等、稍长T1,等、稍长T2信号;增强扫描1例表现为不规则花环样强化,4例病灶不均匀强化,其中3例瘤体囊变明显.结论 非典型性和间变性脑膜瘤均有其各自的影像特点,其多数MR表现差异较大,故两者从影像学上可为临床及病理提供相对可靠的辅助参考.%Objective To explore the MR presentation of the atypical meningioma and the anaplastic meningioma combined with pathological study. Methods It was performed by retrospective analysis to clinical and imaging data to six cases atypical meningioma and five cases of the anaplastic meningioma which all proved by pathology;all of the eleven cases hve been done by plain scan and enhancement scanning. Results In this six cases of atypical meningioma,two cases were in the convex cerebral hemisphere,one case was in the back of cerebellopontine angle,the other two cases were near by the cerebral falx,one case loca-ted in the longitudinal sinus. It was shown that the plain scanning MR presentations of the six atypical meningioma were homo-, low or slightly low signal on T1weighted images; homo-or high or slightly high signal on T2weighted images; The enhancement scanning showed focus of uniformity augmentation in 4 cases; one case presented blotch and institia augmentation in inner of tumour. The augmentation uneven focus in 1 case which all found calcification and capsula,five cases of the anaplastic meningio-ma existed in the convex of the cerebral hemisphere;The plain scan MR of this five cases of anaplastic meningioma presented une-ven homo-or slightly low signal on T1weighted images, homo-or slightly high signal on T2weighted images. one case presented augmentation irregual chaplet form by enhancement scanning. The focus of four cases presented uneven augmentation, in which there were three tumour capsula. Conclusion The images of the atypical meningioma and anaplastic meningioma presented dif-ferent imaging characteristics. Therefore,most of the presentations of MR are different. The two images can provide reliable help-ful reference to the clinic and the pathology.