血管瘤型脑膜瘤的CT与MRI诊断价值比较

Value of CT versus MRI in diagnosis of angiomatous meningioma

  • 摘要:
      背景  血管瘤型脑膜瘤的术前影像精准诊断比较困难,但临床意义重大。
      目的  对比研究CT与MRI检查对血管瘤型脑膜瘤的诊断价值并总结影像特点,提高诊断水平。
      方法  回顾性分析陆军军医大学第二附属医院2009年1月- 2019年6月经病理证实的72例血管瘤型脑膜瘤的CT及MRI检查资料,对比两种诊断方法获得的影像结果与病理结果的一致性。
      结果  血管瘤型脑膜瘤除具有典型的脑膜瘤征象外,部分病灶还可出现浅分叶征、坏死、囊变,增强扫描强化可不均匀,可见明显瘤周水肿、血管流空征及“烟花”征。本研究数据表明MRI对血管瘤型脑膜瘤的检出率较CT检查更具优势65.3%(47/72) vs 31.9%(23/72),P=0.001,差异有统计学意义。
      结论  瘤周明显水肿、血管流空征及“烟花”征是血管型脑膜瘤的特征性影像学征象。MRI对血管型脑膜瘤的定性诊断具有重要参考价值,术其前诊断准确率较CT检查更具优势,其结合CT检查分析可进一步提高血管型脑膜瘤的术前诊断准确率。

     

    Abstract:
      Background  Accurately preoperative imaging diagnosis of angiomatous meningioma is difficult but is of great clinical significance.
      Objective  To compare diagnostic value of CT versus MRI in diagnosing angiomatous meningioma and summarize the characteristics of imaging, so as to improve the diagnostic level of clinicians.
      Methods  From January 2009 to June 2019, the CT and MRI data of 72 cases of angiomatous meningioma confirmed by pathology of the Second Affiliated Hospital of Army Military Medical University were retrospectively analyzed, and the diagnostic results and pathological results of the two different diagnostic methods were compared.
      Results  Angiomatous meningioma had the typical signs of meningiomas, while some lesions also showed shallow lobular signs, necrosis, and cystic changes. On enhanced scan, the angiomatous meningioma enhancement was uneven and showed obvious tumor edema, emptiness of vascular flow and "firework" signs. The data of this study showed that the diagnostic accuracy of MRI for angiomatous meningioma had obvious advantages over CT (65.3% 47/72 vs 31.9% 23/72), and the difference was statistically significant (P=0.001).
      Conclusion  Obvious tumor edema, flow empty phenomena and “firework” signs are the characteristic imaging signs of angiomatous meningioma. MRI has important reference value for qualitative diagnosis and obvious advantages over CT in preoperative diagnosis of angiomatous meningioma. Combined with CT analysis, MRI can be further used for improving the accuracy of preoperative diagnosis of angiomatous meningioma.

     

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