目的：探讨颅内不典型脑膜瘤的MRI表现特点并与组织病理对照，分析误诊原因，以提高脑膜瘤的MRI诊断准确率。材料与方法回顾性分析经手术病理证实的脑膜瘤22例，术前第一诊断均误诊为其他肿瘤，所有病例术前均行MRI平扫及增强扫描，将MRI表现与病理分级分型对照。结果22例误诊病例MR征象：酷似脑内肿瘤的脑膜瘤8例，少见发病部位的脑膜瘤8例，常见部位的脑膜瘤6例；信号不均匀15例，形态不规则、具有侵袭性改变12例。术后病理特点：WHO Ⅰ级12例，WHO Ⅱ级4例，WHO Ⅲ级6例。结论因肿瘤组织学结构复杂、生物学特性差异及少见特殊发病部位，导致了脑膜瘤的不典型MRI表现，充分认识不典型脑膜瘤的MRI表现及其与病理分级分型的相关性，对提高诊断准确率具有重要价值。%Objective: To study the relationship between the atypical meningioma of MRI findings and its pathological features, analyze the reasons of misdiagnosis, to improve the diagnostic level. Materials and Methods:MRI findings of 22 cases meningioma confirmed by surgery and pathology were analyzed retrospectively. All cases were performed enhanced MRI. Results:MRI ifndings of all the 22 cases meningioma were as following: 8 cases were exactly like intracerebral tumors, 8 cases located at uncommon sites, and 6 cases located at conman sites. Fifteen cases showed heterogeneous signal on MRI, 12 cases had invasive boundary. Pathological grade:WHO Ⅰ grade 12 cases, WHO Ⅱ grade 4 cases, WHO Ⅲ grade 6 cases. Conclusions:The reasons for misdiagnosis of meningioma on MRI include complexity of pathological changes, biological characteristics and unexpected locations. A key point of prompting the diagnosis of meningioma is to recognize the atypical ifndings on MRI combined with the pathological features.
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