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目的探讨囊性脑膜瘤的磁共振表现、表观弥散系数(ADC)图的影像特点、ADC值与病理分级的关系及ADC值对判断不同病理亚型脑膜瘤的价值。方法回顾性分析2003年3月-2007年12月18例经病理证实的囊性脑膜瘤患者的磁共振表现,其中男8例,女10例,平均年龄45.6岁。在ADC图上分别测量肿瘤实质、瘤周水肿、囊变区的平均ADC值(均取4～6个区域,取平均值),比较不同病理亚型、不同病理分级的肿瘤实质、瘤周水肿、囊变区的ADC值差异是否有统计学意义。结果良恶性脑膜瘤肿瘤实质ADC值差异无统计学意义(P>0.05);囊性脑膜瘤各亚型间的肿瘤实质、瘤周水肿的ADC值差异无统计学意义(P>0.05);肿瘤实质、囊变区与瘤周水肿平均ADC值相比差异均有统计学意义(P<0.05)。结论 ADC值可区分肿瘤实质、囊变区及瘤周水肿,但对脑膜瘤亚型及良恶性的甄别需结合常规MRI与增强的征象。
Objective To investigate the MRI features of cystic meningioma, the features of apparent diffusion coefficient (ADC) images, the relationship between ADC value and pathological grade and the value of ADC value in judging different pathological subtypes of meningioma. Methods The MRI findings of 18 patients with pathologically confirmed cystic meningiomas from March 2003 to December 2007 were retrospectively analyzed. There were 8 males and 10 females with an average age of 45.6 years. The ADC values of tumor parenchyma, peritumoral edema and cystic area were measured respectively on ADC maps (averaged from 4 to 6, averaged). The tumor types of different histological grade, tumor grade and peritumoral edema , Cystic area ADC value difference is statistically significant. Results There was no significant difference in ADC value between benign and malignant meningiomas (P> 0.05). There was no significant difference in the ADC values between the subtypes of cystic meningioma and peritumoral edema (P> 0.05) The differences between the mean cystic area and the average ADC value of peritumoral edema were statistically significant (P <0.05). Conclusions The ADC value can differentiate tumor parenchyma, cystic area and peritumoral edema. However, the classification of meningioma subtypes and benign and malignant tumors should be combined with conventional MRI and enhanced signs.