非典型性脑膜瘤与良性脑膜瘤MRI征象的对比分析

目的 对比分析非典型性脑膜瘤与良性脑膜瘤的MRI征象特点，提高对非典型性脑膜瘤的认识。方法 回顾性分析经病理证实的37例非典型性脑膜瘤与288例良性脑膜瘤的MRI征象。结果 非典型性脑膜瘤直径>6.5 cm比例、肿瘤呈分叶型比例、瘤脑界面不清晰比例、重度瘤周水肿比例、邻近骨质改变比例均明显高于良性脑膜瘤（P<0.05）。多因素Logistic回归分析显示，肿瘤较大及瘤脑界面不清晰为非典型性脑膜瘤的可能性显著增加，肿瘤大小每增加1.5 cm，非典型性脑膜瘤的概率是良性脑膜瘤的1.507倍，瘤脑界面不清晰为非典型性脑膜瘤的概率是良性脑膜瘤的2.605倍。结论 肿瘤大小及瘤脑界面对于非典型性脑膜瘤与良性脑膜瘤的鉴别诊断具有重要价值。

Comparison of MRI features between atypical and benign meningiomas

Objective To enhance the understanding of MRI features of atypical meningioma and the ability of atypical meningioma diagnosis. Methods MRI data of 37 cases of atypical meningiomas and 288 cases of benign meningiomas confirmed by pathological examination were analyzed retrospectively. The differences of findings including the tumorous size, morphology, location and dural tail sign, tumor-brain interface, peritumoral edema and changes in the adjacent bone on MRI between both the meningiomas were analyzed by the univariate and multivariate Logistic regression analyses. Results There were significant differences in the findings of tumor size and morphology, tumor-brain interface, peritumoral edema and changes in the adjacent bone on MRI between the two groups (P<0.05). The multivariate Logistic regression analysis showed that the bigger meningioma (OR=1.507, P<0.05) and unclear tumor-brain interface on MRI were closely related to the atypical meningioma (OR=2.605, P<0.05). Conclusions Atypical meningioma is significantly different from benign meningioma in the MRI findings, including tumor size and morphology, peritumoral edema, tumor-brain interface and changes in the adjacent bone. The tumor size and tumor-brain interface are more valuable for differential diagnosis of atypical meningioma from benign meningioma.