CT 及MRI 灌注成像对颅内血管外皮细胞瘤 和脑膜瘤的鉴别诊断价值

Differential diagnostic value of CT and MRI perfusion imaging in intracranial hemangiopericytoma and meningioma

摘要:

目的 探讨CT 及MRI 灌注成像在鉴别颅内血管外皮细胞瘤（HPC）和脑膜瘤中的价值。方法 回顾性分析经手术病理证实行灌注成像检查的14 例HPC 患者（HPC 组）和42 例脑膜瘤患者（脑膜瘤组）， 统计分析两者影像形态学及灌注成像参数的差异。结果 7 例HPC 和25 例脑膜瘤患者行CT 平扫及CTP 检查， 7 例HPC 和17 例脑膜瘤患者行MRI 常规及PWI 检查。64.3%（9/14）的HPC 和11.9%（5/42）的脑膜瘤呈 分叶状生长（χ2=12.698，P =0.000）；其他影像形态学比较，差异无统计学意义（P >0.05）。灌注成像HPC 组局部脑血流量（RCBF）、局部脑血容量（RCBV）及RrCBV 高于脑膜瘤组（P <0.05）；两组平均通过时 间比值（RMTT）和达峰时间比值（RTTP）比较，差异无统计学意义（P >0.05）。结论 颅内HPC 和脑膜瘤影 像形态学有较大重叠，但灌注成像参数方面有差异，CT 及MRI 灌注成像有助于提高颅内HPC 术前诊断率。

Abstract:

Objective To investigate the value of CT and MRI perfusion imaging in differentiating intracranial hemangiopericytoma (HPC) and meningioma. Methods A retrospective analysis of 14 patients with HPC and 42 patients with meningioma confirmed by operation and pathology was performed. The imaging morphological and perfusion parameters of them were analyzed statistically. Results Routine CT scan and CT perfusion were performed in 7 cases of HPC and 25 cases of meningioma, 7 cases of HPC and 17 cases of meningioma underwent routine MR and perfusion weighted imaging (PWI). Totally 64.3% (9/14) of HPCs and 11.9% (5/42) of meningiomas were lobulated, the difference was statistically significant (χ2 = 12.698, P = 0.000). RCBF (t = 3.649, P = 0.001), RCBV (t = 2.570, P = 0.015) and RrCBV (t = 2.907, P = 0.008) in perfusion imaging of HPCs were significantly higher than those of meningiomas, while RMTT and RTTP did not differ significantly. Conclusion Intracranial HPC and meningioma overlap a lot in imaging morphology, but there are significant differences in perfusion imaging parameters; CT and MRI perfusion imaging can help to improve the preoperative diagnosis rate of HPC.