脊膜瘤磁共振诊断与病理相关性研究

目的：通过分析脊膜瘤的MRI表现特征、探讨其诊断价值及病理意义。方法：分析术前行MRI检查且经手术和病理检验证实的脊膜瘤患者28例、30个瘤灶,观察肿瘤增强前后的信号改变、瘤体形态及邻近脊膜改变,并进行术后病理检验对照。结果：脊膜瘤MRI特征性表现主要为T1WI等或稍低信号,T2WI等或稍低信号。瘤体内信号较均匀,增强扫描瘤灶呈均质中等强化,形态多为短棒状,可见“脊膜尾征”,病理切片对照显示“尾”实际上其内层是肿瘤组织的延续,外层是异常增厚的脊膜,两层之间无明显分界。结论：脊膜瘤的MRI表现具有较高的特征性,诊断价值极高,定位准确率达100％,定性准确率达93．3％,“脊膜尾征”的“尾”有肿瘤组织成分,且有重要的诊断意义,血管型脊膜瘤易被误诊为神经鞘瘤。

The Correlation of Magnetic Resonance Imaging Diagnostic Manifestation on Meningioma with its Pathological Feature

Objective: To analyse the features magnetic resonance imaging (MRI) on meningioma and investigate the diagnosis value and pathological significance of them.Methods: 28 cases with meningioma (30 focus ) were confirmed by surgery and pathology took MRI examination. Observe the changes of the signals, tumor body and the spinal meniges around tumor before and after enhancement.Results: Meningioma showed iso-signal or slightly low-signal on T1WI, iso-signal or slightly low-signal on T2WI, signals were heterogeneou and intensification after enhancement. Tumors showed short-clubbe-shaped commonly. The "dural tail sign" was found. The pathological analysis showed the internal layer of "tail" was the continuing of the tumor tissues and outer layer was the incrassated spinal menige. There was no obvious borderline between these two layers.The MRI diagnosis of those 28 cases is unique with 100% accuracy of location diagnosis and 93.3% accuracy of qualitative diagnosis.Conclusion: The manifestations of meningiomas are highly characteristic on MRI. The "tail" is the part of the tumor tissues, which has important diagnostic value. In addition, 'vessel sign' is easy to be misdiagnosed as neurilemma.[