恶性脑膜瘤的MRI诊断与鉴别诊断

目的探讨恶性脑膜瘤的MRI表现及鉴别特征。方法对经手术病理证实的23例恶性脑膜瘤的MR图像进行分析。结果肿瘤T1加权像以等、低混杂信号多见,T2加权像呈均匀或混杂高信号;可见囊变及出血信号;增强扫描肿瘤强化不均匀;肿瘤侵犯半球呈磨伞征;边缘不规则或呈锯齿状,硬膜尾征呈粗短不规则形;部分病例向颅内外浸润。结论恶性脑膜瘤MRI表现具有一定特异性,提高识别恶性脑膜瘤的MR表现,有利于临床术前诊断及综合治疗,但须与良性脑膜瘤、胶质母细胞瘤及转移瘤鉴别。

MRI diagnosis and differential diagnosis of malignant meningioma

Objective To study the MRI features of malignant meningioma.Meth od s The MRI findings of 23 cases with malignant meningioma were analyzed, and corr elated with operation and pathology. Results The tumor yielded iso-or hypo-int ensity on T1-weighted images, homogenous or non-homogenous hyper-intensity on T2-weighted images. Irregular enhancement was revealed as well. Malignant meni ngioma had irregular, mushroom pattern margin, dura matter involvement, severe c erebral edema and in some cases, extra-cranial involvement.Conclusion Diagnosti c findings of malignant meningioma could be found on MRI, while it is essential to differentiate a malignant meningioma from a benign one, or a malignant glioma and meningeal metastases.