CAJ | 학술논문

目的分析不同病理类型脑膜瘤的术前磁共振检查特点和临床意义.方法选取我科2004年1月至2014年12月脑膜瘤患者共150例,其中纤维型72例,上皮型54例,血管瘤型10例,非典型8例,间变型6例.所有患者均术前常规行头颅核磁共振检查、磁共振弥散加权成像(DWI)检查和MR灌注成像(PWI).结果各病理类型在T1信号上差异有统计学意义,x2=35.614,P＜0.05;各病理类型在T2信号上差异有统计学意义,x2=85.322,P＜0.05.间变型脑膜瘤的肿瘤实质ADC、rADC显著低于其他类型脑膜瘤,血管瘤型的肿瘤实质ADC、rADC显著高于其他类型脑膜瘤,P＜0.05;纤维型、上皮型和非典型脑膜瘤之间的肿瘤实质ADC、rADC差异无统计学意义,P＞0.05.间变型脑膜瘤的瘤周水肿ADC、rADC显著高于其他类型脑膜瘤,P＜0.05,其他类型脑膜瘤之间的瘤周水肿ADC、rADC差异无统计学意义,P＞0.05.不同病理类型的rCBV、MSD、MSI之间差异有统计学意义,P＜0.05;不同病理类型的rMTF之间差异无统计学意义,P＞0.05.各组参数两两对比,血管瘤型组的rCBV显著高于其它各组,MSD和MSI显著低于其他各组,P＜0.05.结论术前磁共振可初步判断脑膜瘤的病理类型,为手术难度评估和手术方案制定提供一定参考价值.
목적 분석불동병리류형뇌막류적술전자공진검사특점화림상의의.방법 선취아과2004년1월지2014년12월뇌막류환자공150례,기중섬유형72례,상피형54례,혈관류형10례,비전형8례,간변형6례.소유환자균술전상규행두로핵자공진검사、자공진미산가권성상(DWI)검사화MR관주성상(PWI).결과 각병리류형재T1신호상차이유통계학의의,x2=35.614,P＜0.05;각병리류형재T2신호상차이유통계학의의,x2=85.322,P＜0.05.간변형뇌막류적종류실질ADC、rADC현저저우기타류형뇌막류,혈관류형적종류실질ADC、rADC현저고우기타류형뇌막류,P＜0.05;섬유형、상피형화비전형뇌막류지간적종류실질ADC、rADC차이무통계학의의,P＞0.05.간변형뇌막류적류주수종ADC、rADC현저고우기타류형뇌막류,P＜0.05,기타류형뇌막류지간적류주수종ADC、rADC차이무통계학의의,P＞0.05.불동병리류형적rCBV、MSD、MSI지간차이유통계학의의,P＜0.05;불동병리류형적rMTF지간차이무통계학의의,P＞0.05.각조삼수량량대비,혈관류형조적rCBV현저고우기타각조,MSD화MSI현저저우기타각조,P＜0.05.결론 술전자공진가초보판단뇌막류적병리류형,위수술난도평고화수술방안제정제공일정삼고개치.
Objective To analyze the clinical significance and features of pre-operative magnetic resonance imaging (MRI) in meningioma of different pathological types.Methods 150 patients of meningioma in our department from January 2004 to December 2014 were recruited in the study,comprising 72 cases of fiber type,54 of epithelial type,10 of hemangioma,eight of atypical,and six cases of anaplastic type meningioma.Preoperatively,all patients underwent routine cranial MRI,diffusion weighted imaging (DWI) and MR perfusion imaging (PWI).Results The various histological types of meningioma differed significantly from one another in T1 (x2=35.614,P＜0.05) and T2 (x2=85.322,P＜0.05).Compared with the other pathological types,the parenchyma ADC and rADC values were highest for anaplastic meningioma,and lowest for hemangioma (P＜0.05),but these did not differ significantly among fiber type,epithelial type and atypical type meningiomas (P＞0.05).Anaplastic meningioma showed significantly higher ADC and rADC values of the peritumoral edematous region than did the other types of meningioma (P＜0.05),while these values appeared comparable among the other types of meningioma (P＞0.05).There were significant differences in rCBV,MSD and MSI (all P＜0.05) but not in rMTT (P＞0.05),among various pathological types of meningioma.Pairwise comparison of parameters indicated that the hemangioma type meningioma showed significantly higher rCBV and lower MSD and MSI compared with the other pathological types (P＜ 0.05).Conclusion Preoperative MRI may be useful for preliminary judgment of pathological types of meningiomas,thereby providing reference information for surgical difficulty assessment and operation planning.