摘要
目的 探究脑膜瘤患者MRI增强扫描影像学特征,并分析其对临床预后的预测价值.方法 选取2019 年10 月—2022 年10 月收治的87 例脑膜瘤,术前均接受MRI增强扫描,并行肿瘤切除手术和(或)颅底修补术,术后6 个月依据格拉斯哥预后分级(GOS)评估预后,分为预后不良组(GOS Ⅱ～Ⅲ级)、预后良好组(GOS Ⅳ～Ⅴ级).比较不同病理分级患者MRI增强扫描影像学特征,分析影像学特征与病理分级的相关性;比较不同预后患者MRI增强扫描影像学特征,探讨脑膜瘤患者预后不良的影响因素;分析MRI增强扫描影像学特征对患者术后 6 个月预后的预测价值.结果 不同WHO病理分级脑膜瘤患者瘤周水肿、血管流空信号、最大对比增强率(MCER)、肿瘤最大径、肿瘤体积(V)、肿瘤表面积密度(Sv)、容积转移常数(Ktrans)、血管外细胞外容积分数(Ve)比较差异有统计学意义(P<0.05);脑膜瘤患者瘤周水肿、血管流空信号、MCER、肿瘤最大径、V、Sv、Ktrans、Ve与病理分级均呈正相关(P<0.05).预后良好组瘤周水肿、血管流空信号占比低于预后不良组,MCER、肿瘤最大径、V、Sv、Ktrans、Ve水平低于预后不良组(P<0.01).瘤周水肿、血管流空信号、MCER、肿瘤最大径、V、Ktrans、Ve是脑膜瘤患者预后不良的独立影响因素(P<0.05).瘤周水肿、血管流空信号、MCER、肿瘤最大径、V、Ktrans、Ve联合预测患者术后6 个月预后的受试者工作特征曲线下面积最大,大于各指标单独预测(P<0.05).结论 脑膜瘤患者MRI增强扫描影像学特征与病理分级密切相关,联合瘤周水肿、血管流空信号、MCER、肿瘤最大径、V、Ktrans、Ve对脑膜瘤患者预后有较高预测价值.
Abstract
Objective To explore the imaging characteristics of enhanced MRI scanning in patients with meningioma and to analyze its clinical prognostic value.Methods A total of 87 patients with meningiomas admitted from October 2019 to October 2022 were selected,all of whom received enhanced MRI scanning before surgery,followed by tumor resection and/or skull base repair.The prognosis was evaluated at 6 months after surgery according to Glasgow Outcome Scale(GOS),and they were divided into poor prognosis group(GOS grade Ⅱ-Ⅲ)and good prognosis group(GOS grade Ⅳ-Ⅴ).The imaging characteristics of MRI enhanced scanning of patients with different pathological grades were compared,and the correlation be-tween imaging characteristics and pathological grades was analyzed.The imaging characteristics of enhanced MRI scanning in patients with different prognosis were compared,and the influencing factors of poor prognosis in patients with meningioma were investigated.The value of enhanced MRI imaging characteristics in predicting the prognosis of patients at 6 months after sur-gery was analyzed.Results There were significant differences in peritumoral edema,blood vessel flow void signal,maximum contrast enhancement rate(MCER),tumor maximum diameter,tumor volume(V),tumor surface area density(Sv),vol-ume transfer constant(Ktrans)and extracellular volume fraction(Ve)among patients with meningioma of different WHO pathological grades(P<0.05).Peritumoral edema,blood vessel flow void signal,MCER,tumor maximum diameter,V,Sv,Ktrans,and Ve were positively correlated with pathological grade in meningioma patients(P<0.05).The proportion of peritumoral edema and blood vessel flow void signal in the good prognosis group was lower than that in the poor prognosis group,and MCER,tumor maximum diameter,V,Sv,Ktrans and Ve levels were lower than those in the poor prognosis group(P<0.01).Peritumoral edema,blood vessel flow void signal,MCER,tumor maximum diameter,V,Ktrans and Ve were independent influencing factors for poor prognosis in patients with meningioma(P<0.05).The combined prediction of per-itormal edema,blood vessel flow void signal,MCER,maximum tumor diameter,V,Ktrans and Ve had the largest area under the receiver operating characteristic curve,which was greater than that predicted by each indicator alone(P<0.05).Con-clusion Enhanced MRI imaging characteristics of meningioma patients are closely related to their pathological grade,and the combination of peritumoral edema,blood vessel flow void signal,MCER,tumor maximum diameter,V,Ktrans and Ve have higher predictive value for the prognosis of meningioma patients.
基金项目
宿州市科技计划(2021)(SZSKJJZC062)
国家科技期刊平台
NSTL
维普
万方数据