血管瘤型脑膜瘤的MRI表现与病理特征

摘要

Objective To evaluate MRI performances and pathological characteristics of angiomatous meningioma.Methods We retrospectively analyzed the conventional MRI, DWI, ADC values and pathological manifestations of 9 cases of angiomatous meningiomas confirmed pathologically.Results Of 9 cases of angiomatous meningiomas,5 cases were located in convexity of brain,1 case in sphenoid ridge and 3 cases beside cerebral falx.There were 7 cases displayed hypointense on T 1WI and hyperin-tense on T2WI except 2 cases displayed isointense on T 1WI and T2WI.Seven cases manifested flowing void phenomenon,6 cases showed significant peritumoral edema,2 cases displayed necrosis within the tumors.Seven tumors displayed significant enhance-ment on contrast-enhanced T1WI and all cases showed iso-or hyperintense on DWI sequence.The average ADC value of the tumors was higher than the contralateral normal parenchyma(1.29×10-3mm2/s vs.0.89×10-3mm2/s,t =8.32,P <0.01). All tumors were composed of massive micro vessels on pathologic examination.Vimentin and epithelial membrane antigen were positive in all cases.Conclusion Angiomatous meningioma has characteristic structures in pathology and performances on MRI. Combining analysis of conventional MRI,DWI and ADC can help to make a correct diagnosis of this tumor.%目的 探讨血管瘤型脑膜瘤其MRI影像表现与病理学特征.方法 对9例经临床病理证实的血管瘤型脑膜瘤其常规MRI表现、DWI、ADC值及病理特征进行回顾性统计分析.结果 9例血管瘤型脑膜瘤中发生于大脑凸面5例,蝶骨嵴1例,大脑镰旁3例.7例肿瘤T1WI呈低信号,T2WI呈高信号,2例肿瘤T1WI、T2WI均呈等信号.7例肿瘤示血管流空征象,6例肿瘤周围可见明显水肿,2例伴有肿瘤内部囊变坏死,7例肿瘤T1WI增强序列呈明显强化,9例肿瘤DWI均呈等或稍高信号.肿瘤平均ADC值(1.29×10-3mm2/s)大于对侧正常脑实质(0.89×10-3mm2/s)(t =8.32,P <0.01).病理学检查所有肿瘤内均示大量微血管结构,肿瘤波形蛋白染色均呈阳性或弱阳性,上皮膜抗原阳性.结论 血管瘤型脑膜瘤具有特征性病理结构及MRI 表现,常规MRI、DWI 及ADC 值联合分析能够对此肿瘤的正确诊断提供帮助.