WHO(2000)I级脑膜瘤切除程度术前预测参数探讨

Studying preoperative predictor on the level of meningioma WHO(2000) I resection

  • 摘要: 目的: 探讨WHO(2000)I级脑膜瘤术前MR I瘤-脑界面特征及与其相关的病理学表现和临床意义。方法: 观察30个病例的术前MR I脑脊液-血管周围间隙特征和瘤周脑水肿程度、术中肿瘤-脑界面手术分离度(Ilden分型)及术后相应部位脑组织病理学结果,对上述观察指标进行对照分析。结果: Ilden分型与T2W I瘤周水肿级别(P<0.05)、MR I脑脊液-血管周围间隙(P<0.05)显著相关;Ilden分型是预测肿瘤脑侵袭的重要参数(P<0.05);T2W I瘤周水肿级别与肿瘤脑侵袭之间存在显著差异(P<0.05);MR I脑脊液-血管周围间隙不清晰则脑侵袭存在几率增加(P<0.05)。结论: 术前依据瘤周水肿级别(MR I T2W I)、MR I脑脊液-血管周围间隙,可以预测瘤-脑手术分离度(Ilden分型)和肿瘤是否存在脑侵袭。

     

    Abstract: Objective: To study tumour-brain interface of meningioma WHO(2000) I on preoperative MR imaging as well as pathological appearance and clinical significance.Methods: In 30 cases CSF-vessel circum-interspace,peritumoral brain edema on MR imaging,and brain-tumor interfaces in operative performance(Ilden type) were prospectively studied.Biopsies from abnormal brain regions were sent for histological evaluation regarding the presence or absence of tumor invasion of brain.Results: Ildan types,the grade of peritumoral brain edema on T2WI,and CSF-vessel circum-interspace individually seemed to correlate very precisely with the invaded brain tissue by tumors(P<0.05),allowing the prediction of microsurgical effort required during surgery.Additionally,a positive correlation was found between the CSF-vessel circum-interspace and the types of cleavage(P<0.05). Conclusions: The extent of preoperative peritumoral brain edema and CSF-vessel circum-interspace may predict the types of cleavage and invasion of brain.

     

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