Lipid signal in evaluation of intracranial meningiomas
Lipid signal in evaluation of intracranial meningiomas
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DOI：
10.1097/00029330-200812010-00010
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发表时间：
2008-12-05
影响因子：
6.1
通讯作者：
Chen Xin-rong
中科院分区：
文献类型：
--
作者：
Qi Zhi-gang;Li Yu-xin;Chen Xin-rong
背景利用磁共振成像，恶性脑膜瘤由良性脑膜瘤转变为非典型脑膜瘤的诊断尚不确定。方法在3.0T扫描仪上对34例脑膜瘤患者行点分辨波谱(TR/TE 1000/144 ms)H-1磁共振波谱(H-1-MRS)检查。脂峰位于1.3ppm。结果29例脑膜瘤中，良性脑膜瘤11例，纤维性脑膜瘤13例，移行脑膜瘤4例，微囊性脑膜瘤1例。10例脑膜瘤中检出脂质信号：间变性脑膜瘤2例，不典型脑膜瘤3例，纤维性脑膜瘤2例，脑膜上皮性脑膜瘤3例。对来自肿瘤的光谱中具有脂峰的所有体素进行了评估。间变性脑膜瘤、不典型脑膜瘤和良性脑膜瘤以正常脑白质内生肌酸峰为内标，脂质/肌酐比值分别为0.844+/-0.027(0.725~0.994)、0.465+/-0.023(0.239~0.724)和0.373+/-0.016(0.172~0.571)。间变型与其他两种亚型之间存在极显著差异。间变性脑膜瘤呈片状坏死，而不典型脑膜瘤HE染色可见灶性坏死。良性组未见坏死。KP-1染色显示间变性脑膜瘤和不典型脑膜瘤坏死区有组织细胞含脂细胞。结论1.3ppm的脂肪信号是判断脑膜瘤恶性程度的有用指标，特别是在间变性脑膜瘤的鉴别诊断中。
Background Using magnetic resonance imaging, diagnosis of malignant meningioma from benign meningioma with atypical features is uncertain. We evaluated the value of lipid signal in differentiating intracranial meningiomas.Methods H-1-magnetic resonance spectroscopy (MRS) using a point resolved spectroscopy (TR/TE 1000/144 ms) sequences were performed on 34 patients on a 3.0 T scanner. Lipid peak located at 1.3 ppm was evaluated. MRS data from these tumours were compared with histopathological findings (including hematoxylin and eosin staining and KP-1 staining).Results Twenty-nine meningiomas were histologically benign (eleven meningothelial, thirteen fibrous, four transitional and one microcystic), three were atypical, and two were anaplastic. Lipid signal was detected in ten cases: two anaplastic, three atypical, two fibrous and three meningothelial meningiomas. All voxels with lipid peak in the spectrum from the tumour were evaluated. With creatinine peak in the normal white matter chosen as internal standard, lipid/creatinine ratios of anaplastic, atypical and benign meningiomas were 0.844 +/- 0.027 (range from 0.725 to 0.994), 0.465 +/- 0.023 (range from 0.239 to 0.724), and 0.373 +/- 0.016 (range from 0,172 to 0.571) respectively. Highly significant differences were noted between anaplastic and the other two subtypes. Patchy necrosis was observed in anaplastic meningioma, while focal necrosis was noted in atypical meningioma with HE stain. However, no necrosis was found in benign group. KP-1 stain demonstrated histocytes containing lipids in the necrotic region of anaplastic and atypical meningioma.Conclusion The lipid signal at 1.3 ppm is a useful marker in evaluating the malignancy of intracranial meningiomas, especially in the differential diagnosis of anaplastic meningioma.