| Objectives:①explore the meninges pPENT radiological and pathological features.②Analysis meninges pPENT and cPENT, signs of benign meningiomas image differences.③investigate signs of meningeal pPENT images and KI-67, VEGF, P16expression correlation.Methods:Collect all preoperative imaging and postoperative pathological data of the meningeal pPENT, intracranial cPENT and benign meningiomas pathologically confirmed by surgery. The selection of which45cases of wax blocks VEGF, p16immunohistochemical staining. Statistically analysis the dates of imaging, pathology and immunohistochemistry.Results:1. Clinical features:meningeal pPNET6males and4females, age7to58years, mean age21.4±15.83years old. CPNET9males and6females, age6to56years, mean age18.33±15.09years, which has no significant difference with the meningeal pPENT. Meningioma101males and105females, age23to82years, mean age52.43±13.94years, which is significantly higher than PENT. The course of PNET (one month to two years) is significantly less than benign meningiomas (3months to14years).2. comparison between imaging manifest and imaging signs:(1)8cases (80.0%) of the T1WI signal lower than the cerebral cortex;9cases (90.0%) of T2WI signal is higher cortical;9cases (90.0%) is mixed signal;9cases (90.0%) of cystic necrosis;2cases (20.0%) of flow empty signal;8cases (80.0%) of strengthen above degree blood vessels; uneven enhancement (100%);4cases (40.0%) of dural tail sign; one case (10.0%) of severe edema around tumors; lobulated3cases (30.0%);4cases (40.0%) of fuzzy tumor-brain interface;7cases (70.0%) of adjacent bone qualitative change.(2) imaging signs of meningeal pPENT:①T1signal lower than the gray matter:more common than excessive type and meningeal epithelial cells meningiomas (P<0.05).②T2WI signal higher the gray matter:more common than the excessive type and fiber type, meningeal epithelial cells meningiomas (P<0.05).③uneven signal, cystic necrosis, inhomogeneous enhancement:more common than the excessive type, fiber type, meningeal skin cell type, hemangioma meningiomas (P<0.05).④flow empty phenomena:more common than the excessive meningiomas and less than vascular tumor meningioma (P<0.05).⑤strengthen degree higher than the vascular:more common than the excessive type, fiber meningiomas (P<0.05).⑥mild and severe edema around the tumor:less than the cPENT, vascular meningioma (P<0.05).⑦adjacent bone changes:more common than the various other tumors (P<0.05).3pathological features:.①Whether pPENT or cPENT, microscopic signs: closely packed small round cell, nuclei stained, cellular atypia and mitotic figures degree higher than the vascular:more common than the excessive type, fiber meningiomas (P <0.05).6) mild and severe edema around the tumor:less than the cPENT, vascular meningioma (P<0.05).7) adjacent bone changes:more common than the various other tumors (P<0.05).3.pathological features:.(1) Whether pPENT or cPENT, microscopic signs:closely packed small round cell, nuclei stained, cellular atypia and mitotic figures significant, necrotic or cystic common.(2) meningioma:a large number of t swirls umor cells closely spaced, parallelly arranged tumor cells in rich collagen fibers. Meningeal skin cell type tumor cells lobulatly arranged and spaced a little collagen fibers. Hemangioma type:rich blood vessels and the scattered meninges skin cells vortex-like arrangement. Microcapsule-type:elongated cytoplasmic processes, mucus-like substance, eosinophilic cytoplasm.4.Immunohistochemistry:Ki-67strongly positive in18cases, moderately positive in21cases, which has difference and correlation between the cystic necrosis, strengthen and the uniformity of enhance (P<0.05). There is no significant difference between meningeal pPENT and cPENT (P>0.05), was significantly higher than the benign meningiomas (P>0.05). VEGF strongly positive in5cases, the moderately positive in21cases, which has difference and correlation between the cystic necrosis, strengthen and the uniformity of enhance (P<0.05). p16immunohistochemical staining:7cases strongly positive,5cases moderate positive.Conclusion:1.meningeal pPENT:young age of onset, short duration, closely related with the meninges, mostly mixed low signal of T1WI and mixed high signal of T2WI, uneven significantly enhanced, common cystic necrosis, visible bone violations.2.the differential diagnosis of meningeal pPENT with cPENT:relationship with the meninges and the shape of the tumor, meningeal pPENT is more malignant than the benign meningioma, such as the more violations of the skull, but more points are not consistent with the identification of different types of benign meningiomas, which is relevant with histological features.3.meningeal pPENT:immunohistochemical staining Ki-67, VEGF and p16expression.4.among the different score of cystic necrosis and strengthen degree, uniformity of enhance, skull change, the Ki-67, VEGF, p16positive expression rates have differences and a positive correlation (P>0.05). |
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