The Imaging Study Of Classification And Differential Diagnosis To Meningeal Tumor

Part one: The analysis to different types and levels of meningeal tumour’s MR characteristicsObjectives: In different levels,different types of meningeal tumour characteristics of MR were analyzed,get accurate meningeal tumour of the hierarchical classification MR characteristics,improve the preoperative diagnostic accuracy of meningeal tumour,so as to guide clinical operation and curative effect evaluation.Materials and methods: 863 cases confirmed by surgery pathology of different types and levels of meningeal tumour,classified by the onset age,sex ratio and pathological type,to analysis the imaging signs by ten indicators,from the morphology of the tumor edge,peritumor edema,blood flow signals,necrotic cystic change and calcification within the tumor,the relationship between tumor and epidural,T2 WI signal intensity,meningeal tail and bone destruction,enhance the uniformity between meningeal tumour.Statistical methods using independent sample t-test and single factor variance analysis.Results: As increased levels of tumor,the leaf appearance’s incidence increased;In the grade WHO Ⅱ tumor,necrosis’ s chance is 92.31%;of the WHO Ⅰ level in the meninges tumor,calcification’s incidence was 57.49%,most with wide base connected to the dura mater,83.98% of the grade WHO Ⅰ meningioma appeared meningeal tail sign,compared with 86.54% WHO Ⅲ meningeal tumour of T2 signal mixed,uneven enhancement is also at this level in most tumors,bone destruction in the WHO Ⅱ,Ⅲ meningeal tumor occurrence probability were 53.85% and 59.62% respectively,peritumor edema at WHO Ⅲ level meningeal tumor had the highest frequency.Conclusion: calcification,cystic necrosis,edge,enhancement uniformity,these four indexes can be used as a reliable indicator of different levels of differential diagnosis of meningeal tumors.Part two: Study on the application of spectrum CT in the classification of meningiomasObjectives: To evaluate the value of CT spectral imaging in predicting of pathologic types in meningiomas.To discuss spectral CT typing of who grade I meningiomas in the application value,in order to use this new examination method from an image perspective can provide more information for diagnosis of meningioma subtypes,in order to guide the clinical and tumor resection of way selection,prognosis evaluation,to determine the efficacy and predicting the relapse information.Materials and methods: Collected 82 cases of meningiomas confirmed by surgery and pathology.Before the operation,examinaed by energy spectrum CT(discovery ct750 HD,GE Healthcare),82 cases of meningiomas were all WHO grade I meningiomas(epithelial cell type in 33 cases,27 cases of fiber type,transitional type of 32 cases)which can be used in spectrum quantitative CT parameters.Results: At 60 Ke V energy level,Meningothelial,fibrous and transitional meningioma between single energy CT value had significant difference(P < 0.05);at the level of 40-60 Ke V CT value there is significant difference between the three meningiomas;it couldn’t distinguish three kinds of pathological subtypes of meningioma with spectral curve slope and Effective-z.Conclusion: At low energy level,Energy spectrum CT scan could identify the three different subtypes of meningioma of WHO I grade,which could improve the preoperative diagnostic accuracy rate.