| Part1 The clinical value of CE-T2 FLAIR in meningiomaObjective: To investigate the influencing factors and significance of "marginal enhancement sign" on T2 FLAIR enhancement sequence in patients with meningioma.Methods : Collection of Guilin medical college affiliated hospital during January 2019 to December 2020 confirmed by nerve surgical pathology WHO I levels of 30 patients with meningioma,all patients in the preoperative line 3.0T MR scan,including transection T1 WI,T2WI,T2 FLAIR,DWI,ADC,Transverse and sagittal T1 WI scans were performed after enhancement,and T2 FLAIR transversals were added at last.Record the signal values of the lesions in each sequence of T1 WI,CE-T1 WI,T2 FLAIR,CE-T2 FLAIR,and visually observe the enhancement degree of the lesions and the display of the "edge enhancement sign" in each sequence,and count and analyze the appearance of "edge enhancement" on CE-T2 FLAIR The correlation between “signs” and various factors(patients’ gender,age,pathological type,size,location,texture of the tumor and the demarcation of brain tissue and surrounding blood vessels and nerves).Results: In 30 patients with meningioma,the signal values of the lesions were 565(226,620)and 893(714,1055)in plain and enhanced T1 WI sequences.The signal values of T2 FLAIR sequence were 413(368,495)and 565(501,676),respectively,and there was a statistical difference between the two groups(Z=-5.315,P < 0.01).Single factor analysis showed that gender,age,tumor pathological type,size,texture,Ki-67 index,surrounding nerves,blood vessels,and clear boundaries with surrounding brain tissue were not significantly related to CE-T2FLAIR’s “marginal enhancement”(P>0.05),while the tumor location,texture,and S-100 positivity are statistically different in the "marginal enhancement sign" of CE-T2 FLAIR(P<0.05).Linear regression analysis showed that there was no clear linear regression relationship between tumor location,tumor texture,and positive expression of S-100 and CE-T2 FLAIR’s "marginal enhancement sign"(P> 0.05).Conclusions: 1.The signal intensity of meningiomas in CE-T2 FLAIR is lower than CE-T1 WI,and the difference between the two is statistically significant.2.Meningioma CE-T2 FLAIR showed that the "marginal enhancement sign" has a certain correlation with tumor location,tumor texture and positive expression of S-100.After the routine sequence,the T2WI-FLAIR sequence is added to preoperatively for brain tumors.The evaluation has additional clinical value and can be used as an important supplement to the routine MRI sequence without increasing the financial burden of the patient.Part2 The value of CE-T2 FLAIR in the differential diagnosis of intracranial ring-enhanced lesionsObjective: To explore the differential diagnosis value of T2 FLAIR enhanced sequence "marginal enhancement sign" for intracranial ring-enhancing lesions.Methods: 52 patients with an intracranial ring-enhanced lesion were scanned on a 3T MRI scanner using a 32-channel sensor head coil.The MRI scan protocol included T1 WI,T2WI and T2 FLAIR,and sagittal T2 WI.The enhanced MRI scan used rapid injection of gadolinium meglumine(Gd-DOTA)through the elbow vein.Thereafter,the CE-T1 WI and CE-T2 FLAIR were performed.Two radiologists independently assessed and recorded the occurrence rate of the CE-T2 FLAIR “marginal enhancement sign” without knowing the pathological results.The final pathological or follow-up results were used as the standard to estimate the consistency of the diagnosis of the two diagnosing doctors.Last,the chi-square test was applied to analyze whether it is statistically significant.Results: There were 52 patients(49.5±19.0 years old,31 males)of ring-shaped enhanced lesions,including 15 cases of inflammatory lesions and37 cases of neoplastic lesions.Physician 1 judged that the two types of lesions had "marginal enhancement" on CE-T2 FLAIR in 13(13/15)cases and 3(3/37)cases,respectively,with a sensitivity of 87% and specificity of 92%;Physician 2judged that the two types of lesions were in CE-T2 The number of cases with "marginal enhancement" on FLAIR was 14(14/15)and 4(4/37),respectively,with a sensitivity of 93% and a specificity of 89%.The incidence of CE-T2 FLAIR "marginal enhancement sign" in the two types of lesions was statistically different(P<0.05).The two physicians’ judgments on CE-T2 FLAIR "marginal enhancement sign" were consistent,with a Kappa value of 0.913 and P=0.000.22 cases of metastatic tumors and 15 cases of inflammatory lesions showed differences in T1 WI plain scan and the display of "marginal enhancement sign" in each sequence,and the difference was statistically significant(P<0.05).Conclusions: 1.The judgments of different physicians on CE-T2 FLAIR "marginal enhancement sign" are consistent.2.Changes in inflammatory diseases are prone to the CE-T2 FLAIR "marginal enhancement sign".Whether the diagnosis accuracy of inflammatory lesions can be improved by observing the "marginal enhancement sign" still requires a larger sample of data for testing.3.CE-T2 FLAIR and its subtraction images show differences in the "marginal enhancement sign" of metastatic tumors and inflammatory lesions. |
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