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1、囊性脑膜瘤MRI诊断体会(附6例报告)作者:汤永祥单位:244000安徽省铜陵市人民医院MR室【摘要】目的探讨囊性脑膜瘤的MR1特点,提高莫诊断准确性。方法冋顾分析经手术病理证实的6例囊性脑膜瘤的MR1表现。6例均行常规MRI检杏,其中2例加做DWI及MRS。结果采用Nauta分型法,6例囊性脑膜瘤中NautaI型1例、II型2例及IV型3例。术前1例II型和1例IV型均误诊为胶质瘤,另4例确诊。6例发病部位均符合一般典型脑膜瘤特点,5例呈实质性肿块或结节伴大小不一的囊样区,1例NautaII型表现为巨大喪性区
2、为主而瘤实质其少,增强后肿瘤实质均有较明显强化,3例瘤外囊肿壁不强化,3例见脑膜尾征;2例囊性脑膜瘤囊液DWI均呈低信号,且瘤体实质部MRS未见明显NAA峰,但Cho峰明显升高。结论囊性脑膜瘤常规MR1表现具有一定特征性,结合MRS对确诊有一定帮助。【关键词】囊性脑膜瘤磁共振成像诊断MRIdiagnosisofcysticmeningioma(AReportof6Cases)TANGYongxiang,ZHANGJinping,QIANZhen,GAOPing.DepartmentofMRI,TonglingP
3、eople'sHospital,Tongling,AnhuiProvince244000,China[Abstract]ObjectiveTostudytheMRIimagingfeaturesofcysticmeningiomasandtoarisethediagnosticaccuracy.Methods6casesMRIdataincysticmeningiomasconfirmedbytheoperativeandpathologicalresultswereanalyzedretrospectivel
4、y.AllpatientsunderwenttheroutineMRI,inwhich2casesperformedDWIandMRS.ResultsTheimagingtypeofcysticmeningiomawasdividedbyusingNauta.In6cases,onebelongedtoNautaI,2casesNautaIIand3casesNautaIV.OneofNautaIIandoneofNautaIVwereallmisdiagnosedasgliomasbeforeoperatio
5、nandtheotherswereaccuratedlydiagnosed.Thelocationoflesionaccordedwiththecommonmeningiomasoccurredones.5casesappearedtheparenchymatousornodularpartscompanyingwiththediversecysticareas,oneofNautaIIshowedthegiantcystcompanyingwithfewparenchymatouspart.Theparenc
6、hymatouspartsinalltumorshadthemarkedenhancementandthecysticwalloutsidetumorsin3casesnon-enhancement.Themeningealtailsignwasseenin3cases.ThecysticfluidareaswerehypointensitysignalsonDWIin2cases.NAApeakwasnotdemonstratedandChopeakappearedobviouslyhighonMRSin2c
7、ases.ConclusionTheMRIappearanceincysticmeningiomasexistssomechai'acteristics.CombiningMRSisveryhelpfulindiagnosingofthisdisease.[Keywords]Cysticmeningiomas;Magneticresonanceimaging;Diagnosis脑膜瘤是颅内常见肿瘤之一,典型脑膜瘤MR农现有较强的特征性。囊性脑膜瘤临床少见,影像诊断相对易于误诊,尤其是坏死囊变明显者,笔者结合文献
8、,冋顾分析了我院1997年1月金2007年5月间发现的囊性区较明显的6例囊性脑膜瘤的MR表现和特点,探讨MR诊断体会。(资料和方法6例囊性脑膜瘤患者均经手术和病理证实,男2例,女4例,年龄31〜60岁,平均45岁。起病均较缓慢,病程6个月至5年,临床表现以头痛、头昏为主5例,其中1例伴记忆力显苦下降半月,1例以头昏、双下肢乏力2年,加垂伴左眼视力下降3周就诊。使用SiemensNovu