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目的探讨复发性脑膜瘤的MRI表现及病理特点。资料与方法回顾性分析15例复发性脑膜瘤,对其MRI表现及病理特点进行研究。结果 MRI示复发瘤位于大脑镰旁4例、矢状窦旁1例、蝶骨嵴3例、鞍区3例、小脑幕2例、桥小脑角区1例、枕骨大孔区1例;颅内多发7例,形态不规则或分叶状12例,瘤内囊变坏死8例,脑膜尾征4例,瘤周水肿6例,1例发生C5椎体及椎旁软组织转移;瘤体T1WI为等或稍低信号,T2WI和T2FLAIR为略高信号,增强扫描多为明显的不均匀强化。病理证实:恶性13例,良性2例;连续复发7例;良性肿瘤全切术后,首次复发平均时间为3年,而恶性肿瘤为1.4年,连续复发者首次复发后平均每1～2年肿瘤再次复发;组织学类型改变5例,其中4例从低级别向高级别发展。结论复发性脑膜瘤有独特的MRI表现及病理特点,充分认识并确定其特征性改变,有助于提高诊断的准确率。
Objective To investigate the MRI features and pathological features of recurrent meningioma. Materials and Methods Retrospective analysis of 15 cases of recurrent meningioma, MRI findings and pathological features of the study. Results The MRI showed that the recurrent tumor was located in 4 cases beside the falx, 1 in the sagittal sinus, 3 in the sphenoid ridge, 3 in the saddle, 2 in the cerebellum, 1 in the cerebellopontine angle and 1 in the foramen magnum. There were 7 cases with multiple intracranial lesions, 12 cases with irregular or lobulated morphology, 8 cases with necrosis in cyst, 4 cases with meningeal tail syndrome, 6 cases with peritumoral edema, 1 case with C5 vertebral body and paravertebral soft tissue metastasis, T1WI For equal or slightly lower signals, T2WI and T2FLAIR are slightly higher signals, and most of the contrast-enhanced scans are markedly uneven intensities. Pathology confirmed: malignant in 13 cases, benign in 2 cases; 7 cases of continuous recurrence; benign tumor after total resection, the average time for the first relapse was 3 years, and malignant tumors was 1.4 years, the average recurrence of recurrence after an average of 1 to 2 years Tumor recurrence again; histological type change in 5 cases, of which 4 cases from low to high level of development. Conclusions Recurrent meningiomas have unique MRI features and pathological features, fully recognize and identify their characteristic changes, and help to improve the diagnostic accuracy.