目的 探讨巨大囊变脑膜瘤的MRI表现,以提高鉴别诊断水平.方法 收集经手术病理证实的30例巨大囊变脑膜瘤且术前均误诊为胶质瘤的患者,回顾性分析其临床及MRI平扫和增强扫描检查的影像资料.结果 所有病例病理类型中非典型性脑膜瘤所占比例最高,约为33.3％(10/30),而透明细胞型脑膜瘤占26.7％(8/30),纤维细胞型占20％(6/30).MRI表现:宽基底征、脑膜尾征、白质塌陷征、指状水肿征及毛刺征检出率分别为80.0％(24/30)、73.3％(22/30)、70.0％(21/30)、30.0％(9/30)及13.3％(4/30).结论 巨大囊变脑膜瘤的病理类型主要为非典型性脑膜瘤.宽基底征、脑膜尾征、白质塌陷征及毛刺征对巨大囊变脑膜瘤的鉴别诊断有重要价值.%Objective To analyze the MRI features of huge cystic meningioma. Methods Thirty patients, preoperatively misdiagnosed as glioma, confirmed as huge cystic meningioma surgically and pathologically were enrolled in this study. All of the patients underwent plain and enhanced MRI scan and the image data were retrospectively analyzed. Results Atypical meningioma was the most common pathological type of the huge cystic meningioma, which accounted for about 33.3% (10/30), followed by clear cell meningioma 26.7% (8/30), fiber cell 20% (6/30). The rates of the MRI signs including broad-based-dural-attachment sign, dural tail sign, white matter collapse sign, digitate-edema sign and spicule sign were 80.0% (24/30), 73.3% (22/30), 70.0% (21/30), 30% (9/30) and 13.3% (4/30), respectively. Conclusion The pathological type of the huge cystic meningioma was mainly atypical meningioma. The MRI signs including broad-based-dural-attachment sign, dural tail sign, white matter collapse sign and spicule sign have high value in differential diagnosis of huge cystic meningioma.
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