MRI鉴别囊变脑膜瘤与脑表面囊变胶质瘤的价值

摘要

目的:探讨囊变脑膜瘤与靠近脑表面囊变胶质瘤的MRI表现,以提高鉴别诊断水平.方法:回顾性分析经术后病理证实的囊变脑膜瘤38例与靠近脑表面囊变胶质瘤21例,分析增强后病灶边缘的"脑膜尾征"、"白质塌陷征"、"毛刺征"及"指状水肿征"、"宽基底征"及"强化均匀"的例数,并作统计学分析.结果:脑膜瘤组的脑膜尾征、白质塌陷征、毛刺征、宽基底征、指状水肿征及肿瘤实质强化均匀的检出率分别为73.7%(28/38)、76.3%(29/38)、10.5%(4/38)、81.6%(31/38)、23.7%(9/38)及57.9%(22/38);而胶质瘤组则分别为23.8%(5/21)、19.0%(4/21)、38.1%(8/21)、57.1%(12/21)、52.4%(11/21)及33.4%(7/21).白质塌陷征、脑膜尾征、宽基底征、毛刺征及指状水肿征在脑膜瘤组与胶质瘤组差异有统计学意义(P<0.05);肿瘤实质强化均匀在二组间差异无统计学意义(P>0.05).结论:脑膜尾征、白质塌陷征,宽基底、毛刺征、指状水肿征对鉴别脑膜瘤与胶质瘤价值较大,而强化较均匀对二者的鉴别意义不大.%Objective: To explore the value of MRI in the differentiation between cystic meningioma and cystic glioma adjacent to brain surface. Methods: A retrospective analysis of MRI examinations was performed in 38 patients with cystic meningioma and 21 patients with cystic glioma adjacent to brain surface. All the lesions were proved by pathology. The MRI signs of the lesions were detected for statistical analysis including dural tail sign, white matter collapse sign, spicule sign,digitate-edema sign, broad-based-dural-attachment sign and homogeneous enhancement of tumor parenchyma. Ruslts: The rates of those signs for cystic meningioma identification were 73.7 ％ (28/38) ,76.3 ％ (29/38) ,10.5 ％ (4/38) , 81.6 ％ (31/38) ,23.7％ (9/38) and 57.9％ (22/38) , respectively. The rates of those signs for cystic glioma identification were 23.8 ％(5/21) ,19.0 ％ (4/21) ,38.1 ％ ( 8/21) , 57.1％ (12/21) , 52.4％ (11/21) and 33.4％ ( 7/21) respectively. Statistically significant differences were found in dural tail sign, white matter collapse sign, spicule sign, digitate-edema sign, broad-based-dural-attachment sign between cystic meningioma and cystic glioma adjacent to brain surface (P＜0.05). No significant differences were found in homogencous enhancement of tumor parenchyma between cystic meningioma and cystic glioma adjacent to brain surface ( P＞0.05). Conclusion : The signs on MRI including dural tail sign, white matter collapse levy , spicule sign,digitate-edema sign,broad based dural attachment sign have high value in differentiation between cystic meningioma and cystic glioma adjacent to brain surface,except for homogeneous enhancement of tumor parenchyma.