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目的 探讨血管瘤型脑膜瘤的MRI特点，并与其他WHOⅠ级脑膜瘤进行鉴别。方法 回顾性分析经手术病理确诊的16例血管瘤型脑膜瘤及67例其他WHOⅠ级脑膜瘤患者MRI图像资料，定性参数分析各组MRI各序列信号特征，包括边界、分叶、囊变坏死、脑膜尾征、钙化、出血、邻近颅骨骨质改变、T1WI信号、T2WI信号、瘤周水肿及流空血管。定量参数分析包括ADC值及强化程度比值。对各组定性及定量资料进行统计学分析。结果 16例血管瘤型脑膜瘤中，4例T2WI为等信号，12例T2WI信号为稍高信号；8例瘤周水肿为重度，4例为轻度，4例为中度；12例(75%)显示流空血管，T2WI信号、瘤周水肿及流空血管征象与其他各亚组比较，差异有统计学意义(P<0.05)。血管瘤型脑膜瘤ADC值及强化程度平均值分别为(1.16±0.19)×10-3mm/s2、4.74±0.53，与其他各亚组比较，差异均有统计学意义(P<0.05)。边界、分叶、囊变坏死、脑膜尾征、钙化、出血、邻近颅骨骨质改变及T1WI信号与其他各亚组比较无明显统计学差异。结论 血管瘤型脑膜瘤的MRI表现有一定特征，T2WI高信号，可见流空血管，瘤周水肿及强化程度明显，实性成分有较高的ADC值。
Abstract：Objective To investigate the MRI features of angiomatous meningiomas and to identify the imaging findings that differentiate them from other WHO grade I meningiomas. Methods A retrospective analysis was performed on MRI data of 16 patients with pathologically confirmed angiomatous meningiomas and 67 patients with other WHO grade I meningiomas. Qualitative assessments included lesion margin, lobulation, cystic or necrotic change, dural tail sign, calcification, intratumoral hemorrhage,adjacent skull changes, signal intensity on T1WI and T2WI, peritumoral edema, and the presence of flow void vessels. Quantitative analysis focused on the apparent diffusion coefficient(ADC) values and enhancement degree ratios. Comparisons were conducted for both qualitative and quantitative data between the two groups. Results Of the 16 angiomatous meningiomas cases, 4 cases showed isointensity on T2WI, 12 cases showed slightly hyperintense signals on T2WI. Eight cases presented with severe peritumoral edema,moderate in 4 cases, and mild in 4 cases. Flow void vessels were present in 12 cases(75%), with a significant difference compared with other WHO grade I meningiomas( P <0.05). The mean values of ADC and enhancement degree in angiomatous meningiomas were(1.16±0.19)×10-3mm/s2 and 4.74±0.53, respectively, both of which were significantly higher than those ofthe other subgroups(all P <0.05). There were no significant statistical differences in boundary, lobulation, cystic necrosis, dural tail sign, calcification,tumor hemorrhage, adjacent skull changes and T1WI signal when compared with other subgroups. Conclusion Angiomatous meningiomas present distinctive MRI characteristics, including hyperintensity on T2WI, the presence of flow void vessels, obvious peritumoral edema and enhancement, as well as relatively high ADC values.
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基本信息:
DOI：
中图分类号:R739.45;R445.2
引用信息:
[1]吴霜,梁宗辉.血管瘤型脑膜瘤的MR诊断及与其他WHOⅠ级脑膜瘤的鉴别[J].影像诊断与介入放射学,2025,34(05):350-356.
基金信息:
上海市静安区中心医院医学创新“种子基金”项目(JZ-2021zz07); 2024年度上海市卫生健康系统重点学科建设项目(2024ZDXK0061)