| Objective: To study the CT and MRI features of skull base communicatingmeningiomas and the value of CT and MRI in the qualitative diagnosis andlocalization diagnosis of skull base communicating meningiomas, in order toimprove the preoperative diagnosis accuracy of tumors and providemorevaluable information for clinical.Methods:35cases of skull base communicating meningiomas which wereconfirmed by operations and pathological examinations in our hospital betweenFebruary2009to January2015were retrospectively studied. The positive rateof CT and MRI in qualitative diagnosis and the positive rate of the invasion ofthe adjacent bone and soft tissuewere calculated respectively.SPSS11.5softwarewas used for statistical processing, and X2test was performed for statisticalanalysis. P <0.05was regarded as statistically significant.Results: According to the involved area,cranio-orbital communicating wasfound in24cases(68.57%), cranio-nasal communicating was found in9cases(25.71%）and cranio-cervical communicating was found in2case(5.71%).The dumbbell-shapedor irregular-shaped form was shown in most cases,andmass effectwere shown in all35cases. The anatomy cavity of the skull base wasdeformed or enlarged to a certain extent in29cases (82.86%). Tumorsshowedhomogeneousisodense or slightlyhigh-density in CT scan. Spotty, patchy calcification was found in11cases of tumors.32cases showedosteosclerosis or destruction of the skull base bones at CT bone window. MRIfindings of most tumors presented as homogeneous iso-or slightly longer signalintensity on both T1WI and T2WI, and5cases (14.29%) showed small cysticnecrosis without bleeding in tumor. Gd-DTPA enhanced scanning of the tumorsshowed homogenis remarkable enhancement, and dural tail sign was detected in23of35cases （65.71%）.33cases clearly displayed the extent ofthe lesions spread to the surrounding soft tissue in MRI with application ofenhanced fat suppressed sequence. The positive rate of CT and MRI in thediagnosis of skull base communicating meningiomaswas85.71%and91.43%respectively,no significant difference between them (χ2=0.14,P>0.05);Thepositive rate of CT and MRI in the diagnosis of the invasion of the surroundingbone was88.57%and65.71%respectively,there are significant differencesbetween them (χ2=5.19,P<0.05), the positive diagnosis rate of tumor invadingthe surrounding bone in CT examination was higher than MRI; The positive rateof CT and MRI in the diagnosis of the invasion of the surrounding soft tissuewas68.57%and94.29%respectively, there are significant differences betweenthem(χ2=7.65,P<0.05),the positive diagnosis rate of tumor invading thesurrounding soft tissue in MRI examination was higher than CT.Conclusion: Skull base communicating meningioma havecharacteristic features in CT and MRI imaging findings. Expanded channel ofthe skull base lesions, osteosclerosis or destruction of the bone of adjacent tumor and small patchy calcification in lesions were clearly shown in CT scan.But in terms of showing the violation of early small bone erosion and tumor onthe surrounding soft tissue, CT displayed less sensitivity than MRI.The range of the intra-extracranial lesions spreaded were shown clearlyespecially after the use of enhanced fat suppressed sequences in MRI scan.And the disappearance of the high signal of normal bone marrow can be usedto visually detect the extent and range of skull base destruction in T1WIsequence. The largest value of image examination is the location diagnosis inskull base communicating meningiomas. The integrated use of CT and MRIexamination can mutually make up for their shortcomings, which can clearlyshow the tumor site, communication path and changes in surrounding structures,and help provide valuable information on treatment and surgical approaches．... |
PDF Full Text Request