脑膜瘤影像分析及鉴别诊断

目的探讨脑膜瘤CT及MRI表现,总结对脑膜瘤征象的认识,以提高对其的诊断及鉴别诊断。方法回顾性分析我院经手术病理证实的脑膜瘤47例,对其影像学特点与发生部位、病理类型等进行总结。结果病变位于额部21例,额颞交界处7例,顶部3例,颞部3例,右桥小脑角3例,右额骨内1例,大脑镰旁5例,鞍旁4例;WHOⅠ级30例,WHOⅡ级16例,WHOⅢ级1例;脑膜瘤大部分密度均匀,在CT上表现为等或稍高密度,T1WI呈等或稍低信号,T2WI呈等或高信号,增强扫描呈均匀的明显强化;17例瘤周脑实质出现明显水肿;4例瘤内见较多的钙化;34例可见脑膜尾征;23例见"瘤脑面重度强化带"。结论脑膜瘤在CT、MRI检查中具有一定的特征性,术前基本上可明确诊断;非典型影像学表现则需与脑部其他肿瘤鉴别。

Imaging Analysis and Differential Diagnosis of Meningioma

Objective To investigate the CT and MRI findings of meningiomas, and to summarize the knowledge of meningioma signs, in order to improve the diagnosis and differential diagnosis of meningiomas. Methods A retrospective analysis of 47 cases of meningioma confirmed by operation and pathology in our hospital was made. The imaging features, location and pathological types were summarized. Results The lesions were located in 21 cases, 7 cases of frontal and temporal junction, 3 cases in the top, 3 cases in the temporal region, 3 cases in the right cerebellar angle, 1 cases in the right frontal bone, 5 cases in the right frontal bone, 5 cases in the sickle, 4 cases in the para saddle, 30 cases in the WHO grade I, 16 cases in the WHO grade II, and case 1 case in the WHO grade III;most of the meningiomas are equal or slightly high in CT, T1 WI is equal or a little lower. The signal, T2 WI was equal or high signal, the enhanced scan was obviously enhanced, 17 cases showed obvious edema in the parenchyma of the brain, 4 cases had more calcification in the tumor, 34 cases showed meningeal tail sign and 23 case of "the markedly enhanced-rim facing the brain of lesion". Conclusion meningioma has some characteristics in CT and MRI examination. The diagnosis of meningioma is basically clear before operation, and the atypical imaging features need to be identified with other brain tumors.