颅内血管外皮细胞瘤与血管瘤型脑膜瘤的MRI与病理对照

目的：对比分析颅内血管外皮细胞瘤与血管瘤型脑膜瘤的MRI表现，并与病理对照。材料与方法：收集我院经手术病理证实血管外皮细胞瘤19例，血管瘤型脑膜瘤25例，对其MRI与病理表现进行回顾性比较分析。结果：MRI示19例颅内血管外皮细胞瘤肿瘤均位于颅内脑外，MR平扫T1WI呈高低不均信号15例，等信号4例，T2WI呈不均匀高信号15例，等信号4例；增强扫描14例呈不均匀显著强化；窄基底与脑膜相连11例；颅骨破坏6例。25例血管瘤型脑膜瘤MR平扫T1WI均匀较低信号及T2WI均匀较高信号21例，23例病灶显著均匀强化，16例呈宽基底与脑膜相连。病理示两种肿瘤来源不同。结论：颅内血管外皮细胞瘤MRI与血管瘤型脑膜瘤其起源不同，而MRI则十分相似，前者是恶性肿瘤，往往出现分叶征、跨叶生长、与硬膜呈窄基底相连、有丰富的血管、肿瘤易出血坏死致信号不均匀、破坏邻近颅骨等特点，据此可与后者鉴别。

Comparison of MRI sign and pathological findings in intracranial hemangiopericytomas and angiomatous type meningioma

Objective: To analyse MRI features of intracranial hemangiopericytomas and angiomatous type meningioma, and correlate with their pathology. Materials and Methods: Ninteen cases of intracranial hemangiopericytomas and 25 cases angiomatous type meningioma were verified by pathology. MRI with and without contrast medium were performed in all 44 cases. Results: All patients were of extraaxial tumors. Fifteen of the 19 cases were heterogeneous in intensity isointense to cortical gray matter in 4 cases on T1WI; 15 of 19 cases were heterogeneously iso-hyperintense signal and the other 4 cases were isointense on T2WI. Fourteen of the 19 cases were heterogeneously enhanced on contrast-enhanced T1WI. Conclusion: Intracranial hemangiopericytomas is similar to meningiomas on MRI, but they can be distinguished according to MRI features of intracranial hemangiopericytomas: multiobulated, rich in vascular flow in the tumor, heterogeneous signal intensity, hyperostosis and no intratumoral calcification, the tumor used to have adjacent bone destruction.