本文選題：腦膜瘤　切入點(diǎn)：常規(guī)MR成像　出處：《川北醫(yī)學(xué)院》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：對(duì)腦膜瘤術(shù)前MRI常規(guī)掃描序列的影像特征進(jìn)行分析，與病理結(jié)果對(duì)照，探討常規(guī)磁共振掃描區(qū)分良、惡性腦膜瘤和常見亞型腦膜瘤的可行性。 材料與方法：回顧性分析139例（其中121例進(jìn)行了亞型的區(qū)分）已被病理證實(shí)為腦膜瘤的患者術(shù)前頭顱MRI影像，觀察病灶的位置、腫瘤大小、形態(tài)、瘤周水腫程度和腫瘤在T1WI、T2WI、T2Flair等MRI常規(guī)序列上的信號(hào)強(qiáng)度。比較上述影像表現(xiàn)在良惡性腦膜瘤之間及不同亞型腦膜瘤之間的差異。同時(shí)對(duì)患者年齡、性別等一般因素進(jìn)行統(tǒng)計(jì)分析。 結(jié)果：本組139例腦膜瘤中WHOⅠ級(jí)130例、WHOⅡ、Ⅲ分別為6例和3例，良性腦膜瘤中纖維型、上皮型、混合型和血管瘤型、微囊型是主要亞型(分別為46例,35例,17例和7例，3例)。 1、年齡、性別:發(fā)病年齡在良、惡性腦膜瘤組間及不同亞型間無統(tǒng)計(jì)學(xué)差異；各主要亞型腦膜瘤在不同性別比例中有差異，纖維型腦膜瘤好發(fā)于女性，上皮型腦膜瘤在男性占較大比例(P=0.01)。 2、腫瘤大小、形態(tài)發(fā)生位置:腫瘤平均直徑在良、惡性腦膜瘤組間及不同亞型間比較，差異均無統(tǒng)計(jì)學(xué)意義。腫瘤形態(tài)在良、惡性腦膜瘤組間差異有統(tǒng)計(jì)學(xué)意義（p=0.043），惡性腦膜瘤多表現(xiàn)為明顯分葉狀；主要亞型中纖維型腦膜瘤以形態(tài)規(guī)則和淺分葉為主，非典型、血管瘤型多表現(xiàn)為分葉狀（P＜0.05）。130例良性腦膜瘤，發(fā)生于顱底面26例，9例惡性腦膜瘤發(fā)生于顱底面6例，差異有統(tǒng)計(jì)學(xué)意義(p=0.005)。纖維型VS上皮型（p=0.001），纖維型VS非典型（p=0.005）,亞型的位置分布差異有統(tǒng)計(jì)學(xué)意義。 3、瘤周水腫：良、惡性腦膜瘤組間瘤周水腫程度比較無統(tǒng)計(jì)學(xué)差異（p=0.291；主要亞型瘤周水腫程度為上皮型＞非典型＞血管瘤型＞微囊型＞混合型＞纖維型，其中上皮型VS纖維型(P＜0.01)、上皮型VS混合型(P=0.002)，非典型VS纖維型(P=0.023)，差異有統(tǒng)計(jì)學(xué)意義。腦膜瘤由小到大水腫出現(xiàn)率分別為37.73%、78.43%、88.57%，腫瘤大小與水腫程度呈正相關(guān)性（r=0.312**、 P＜0.01）. 4、MR常規(guī)序列腫瘤信號(hào)強(qiáng)度：良、惡性兩組進(jìn)行比較，腫瘤信號(hào)強(qiáng)度在各序列上無統(tǒng)計(jì)學(xué)意義（p＞0.05）。主要亞型中微囊型、血管瘤型T1WI序列信號(hào)低于其它亞型、T2WI序列信號(hào)高于其它亞型，差異均有統(tǒng)計(jì)學(xué)意義（p＜0.05）。其余亞型T1WI信號(hào)差異無統(tǒng)計(jì)學(xué)意義。T2Flair序列上述亞型信號(hào)差別均無統(tǒng)計(jì)學(xué)意義。 結(jié)論：常規(guī)MR掃描序列存在部分特征性影像表現(xiàn)，對(duì)于腦膜瘤良惡性以及亞型區(qū)分有一定作用，能對(duì)部分亞型的生物學(xué)行為予以提示。 目的：探討彌散加權(quán)（DWI）圖像信號(hào)和表觀彌散系數(shù)(ADC)能否在術(shù)前區(qū)分出不同病理級(jí)別或病理亞型的腦膜瘤，為臨床手術(shù)方式和治療方案的選擇提供幫助。 材料與方法：對(duì)94例已被病理證實(shí)為腦膜瘤患者的術(shù)前頭顱MRI圖像進(jìn)行回顧性實(shí)驗(yàn)研究，觀察DWI圖像腫瘤信號(hào),以腦皮質(zhì)為參照記為低信號(hào)、等信號(hào)及高信號(hào)；在ADC圖像上分別測量腫瘤實(shí)質(zhì)平均ADC值、最小ADC值、最大ADC值。將DWI信號(hào)、ADC測量結(jié)果分別與病理分級(jí)、分型對(duì)比分析。 結(jié)果： 1、DWI信號(hào)強(qiáng)度在良、惡性腦膜瘤組間無統(tǒng)計(jì)學(xué)差異（P=0.379）。微囊型腦膜瘤DWI信號(hào)以高、明顯高信號(hào)為主，，但與其它亞型比較無統(tǒng)計(jì)學(xué)差異（P=0.201）。 2、良、惡性腦膜瘤平均ADC值為（97.34±18.53VS89.83±7.79）×10-5mm2/s、最小ADC值(92.61±16.95VS85.42±7.11)×10-5mm2/s、最大ADC值(103.49±20.96VS94.52±8.14)×10-5mm2/s，各組ADC值均為良性組高于惡性組，但組間差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。主要亞型中血管瘤型平均ADC值（129.00±20.90）×10-5mm2/s，最小ADC值（122.60±20.51）×10-5mm2/s，最大ADC值（136.71±22.16）×10-5mm2/s,各組ADC值均高于其它亞型，差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。 結(jié)論：本次實(shí)驗(yàn)結(jié)果顯示，磁共振彌散加權(quán)成像（DWI）和ADC值在良、惡性腦膜瘤組間無統(tǒng)計(jì)學(xué)差異，但DWI和ADC可以對(duì)部分亞型進(jìn)行區(qū)分，對(duì)腦膜瘤亞型的診斷有一定的價(jià)值。
[Abstract]:Objective: to analyze the imaging features of preoperative MRI routine scanning sequence and compare with pathological findings, and explore the feasibility of conventional magnetic resonance imaging in differentiating benign from malignant meningioma and common submeningioma.
Materials and methods: a retrospective analysis of 139 cases (including 121 cases of sub type) have been pathologically confirmed meningiomas before surgery in patients with cranial MRI images, observed the location of the lesion, tumor size, shape, and degree of peritumoral edema and tumor in T1WI, T2WI, T2Flair and MRI signal intensity of conventional sequence. The difference in the image. A comparison between benign and malignant meningiomas and different subtypes of meningioma. While patients with age, gender and other general factors were analyzed.
Results: in 139 cases of meningiomas, there were 130 cases of WHO grade I, 6 cases of WHO II and 3 cases of benign meningiomas. There were fibrous, epithelial, mixed and hemangioma types in the benign meningiomas. The subtypes of microcapsules were mainly subtypes (46 cases, 35 cases, 17 cases and 7 cases, 3 cases), respectively.
1, age and gender: there was no significant difference in age of onset between benign and malignant meningioma group and between different subtypes. Meningiomas of all major subtypes were different in different sex ratios. Fibrous meningiomas were frequent in females, and epithelial meningiomas were larger in males (P=0.01).
2, tumor size, morphogenetic position: the mean diameter of the tumor in benign and malignant meningiomas, comparison between groups and different subtypes, there were no significant differences in tumor morphology. In benign and malignant meningioma was statistically significant difference between groups (p=0.043), malignant meningioma showed obvious lobulated; major subtypes in fiber type with meningioma morphological rules and superficial lobulation, atypical hemangioma type showed lobulated (P < 0.05).130 cases of benign meningiomas, 26 cases occurred on the surface of skull base, 9 cases of malignant meningiomas in 6 cases of skull base surface, the difference was statistically significant (p=0.005). Fiber type VS epithelial (p=0.001) fiber type, atypical VS (p=0.005), was statistically significant difference position distribution of subtypes.
Zhou Shuizhong: good, 3 tumors had no significant difference between the groups of malignant meningioma peritumoral edema (p=0.291; main subtypes of peritumoral edema in epithelial type, atypical angiomatous type > > > > were mixed type fiber type, the epithelial type VS fiber type (P < 0.01), skin type VS mixed type (P=0.002), atypical type VS fiber (P=0.023), the difference was statistically significant. The rate was 37.73%, 78.43% from 88.57% meningioma appeared edema, edema, tumor size and degree of positive correlation (r=0.312**, P < 0.01).
4, conventional MR imaging signal intensity of lesions were compared between the two groups: benign, malignant tumor, signal intensity was not statistically significant in each sequence (P > 0.05). The main microcystic subtypes, hemangioma type T1WI sequence signal is lower than that of other subtypes, the T2WI sequence signal is higher than other subtypes, the differences were statistically significant (P < 0.05). The other subtypes of T1WI signal.T2Flair there were no significant differences between the subtypes of signal sequence differences were not statistically significant.
Conclusion: there are some characteristic imaging findings in conventional MR scanning sequences, which is helpful for differentiating benign and malignant meningiomas and subtypes. It can prompt some biological behaviors of subtypes.
Objective: To investigate whether diffusion-weighted (DWI) image and apparent diffusion coefficient (ADC) can differentiate the meningiomas with different pathological grades or pathological subtypes before operation, so as to provide help for the selection of surgical procedures and treatment options.
Materials and methods: 94 cases had been pathologically confirmed meningiomas. The preoperative cranial MRI images were retrospectively study, observation of tumor DWI image signal in cerebral cortex as the reference signal recorded as low signal and high signal in ADC images were measured; the average ADC value of tumor parenchyma, the minimum ADC value. The maximum value of ADC. DWI signal, ADC measurement results were compared with the pathological classification, analysis of contrast.
Result錛

本文編號(hào)：1627932