MRI及CT诊断在颅底沟通性脑膜瘤患者中的应用对比及其预后分析

目的:探讨MRI和CT诊断在颅底沟通性脑膜瘤患者中的应用及其预后分析。方法:选取2017年5月—2020年5月住院治疗的104例颅底沟通性脑膜瘤患者，均行CT和磁共振检查，研究两种检查方式的诊断正确性及损害周边骨质及软组织的相符度。结果:CT诊断准确率为85.6%，MRI为92.3%，两种方式准确率差异无统计学意义（P＞0.05）；在颅底沟通性脑膜瘤损害周边骨质及软组织的诊疗中，MRI检查的正确率高于CT检查（骨质:χ2 =5.291，P＜0.05；软组织:χ2 =7.565，P＜0.05）。利用Logistic回归发现，肿瘤大小、信号不均及明显水肿是提示预后不良的敏感性指标（肿瘤大小:OR=1.045，P=0.002，95% CI:1.017～1.075；信号不均:OR=12.096 5，P=0.015，95%CI:1.648～101.992；明显水肿:OR=0.062，P=0.043，95% CI:0.004～0.919）。结论:MRI和CT对颅底沟通性脑膜瘤的诊断正确率类似，但在对周边骨质或软组织损害的诊断中，磁共振检查正确率更高，并且肿瘤大小、信号不均及明显水肿与预后不良相关。

Comparison of MRI and CT diagnosis in patients with skull base communicating meningioma and analysis of its prognosis

Objective: To investigate the application of MRI and CT in the diagnosis of meningioma in the skull base and its prognosis. Methods: A total of 104 patients with skull base communicating meningioma who were hospitalized from May 2017 to May 2020 were enrolled. All patients underwent CT and MRI. Diagnostic accuracy and compliance with surrounding bone and soft tissue were compared. Results: Accuracy rate of CT diagnosis was 85.6%，while MRI was 92.3%，there was no difference in the diagnostic accuracy of the two methods（P>0.05）. In the diagnosis of peripheral bone and soft tissue invading the skull base communicating meningiomas，the diagnostic compliance rate by MRI was higher than that of CT（bone: χ2=5.291，P＜0.05；soft tissue: χ2=7.565，P＜0.05）. Logistic regression showed that tumor size，uneven signal intensity and obvious edema were sensitive indicators of poor prognosis（tumor size:OR=1.045，P=0.002，95% CI: 1.017-1.075；uneven signal intensity:OR=12.096 5，P=0.015，95% CI:1.648-101.992; obvious edema:OR=0.062，P=0.043，95% CI: 0.004-0.919）. Conclusion:MRI and CT have similar diagnostic accuracy in communicating meningioma of skull base，but MRI has higher diagnostic accuracy in peripheral bone or soft tissue damage. Tumor size，uneven signal intensity and obvious edema are associated with poor prognosis.