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目的 探讨脑膜瘤硬脑膜尾征的病理基础及其临床意义。方法 对 46例脑膜瘤患者行SimpsonⅠ级肿瘤全切除 ,包括肿瘤基底周围至少 2 0mm的硬脑膜 ,并行病理学检查 ;比较有无MR硬脑膜尾征者的病理学表现。结果 MR增强扫描显示硬脑膜尾征阳性者 2 8例(60 9% ) ,其中 1 8例病理结果显示有硬脑膜的肿瘤细胞浸润 ,1 0例仅见组织增生 ,血管扩张和丰富的血供 ;而MR增强扫描中未见硬脑膜尾征的 1 8例中 ,有 6例经病理证实肿瘤浸润邻近硬脑膜。结论 MR检查不能确定硬脑膜是否已被肿瘤浸润 ,硬脑膜尾征应结合其他的影像学特征如肿瘤的形状、边界以及瘤周水肿的程度等综合判断 ,决定是否作更具侵袭性的手术。
Objective To investigate the pathological basis and clinical significance of meningioma tail duo sign. Methods Forty-six patients with meningioma underwent total resection of Simpson class I tumor, including at least 20 mm surrounding dura mater, and pathological examination was performed. The pathological findings of MR dural tail were compared. Results There were 28 cases (60.9%) of the positive signs of dura mater in MR enhancement scan. Of the 18 cases, 18 cases showed infiltration of tumor cells in dura mater and only 10 cases of hyperplasia, vasodilation and abundant blood supply. Of the 18 cases with no dural tail signs in the MR contrast-enhanced scan, 6 were histologically confirmed to have infiltrated adjacent dura mater. Conclusions MR examination can not determine whether the dura mater has been infiltrated by the tumor. The dura mater tail should be combined with other imaging features such as the shape and boundary of the tumor and the extent of peritumoral edema to decide whether to make more invasive surgery.