| Objective(s): Firstly,to compare the differences of benign and malignant meningiomas in Contrast-enhanced T2 Fluid Attenuated Inversion Recovery(CE-T2-FLAIR).Secondly,to explore the value of CE-T2-FLAIR in the differential diagnosis of meningiomas,high-grade gliomas and metastases located on the surface of the brain.Methods:1.134 patients with clinically suspected meningioma from September 2018 to January 2023 suffered heard MRI routine scan,enhanced scan and heard CT routine scan.Finally,125 patients with pathologically confirmed meningioma were enrolled.In all enrolled patients,100 patiente were of benign meningioma and 25 patients were of malignant meningioma.Bone destruction,peritumoral brain edema,and enhancement of CSF spaces at the margin of tumor parenchyma were assessed by vision,ADC value of solid component and diameter were obtained by measurement.Firstly,the gender and age of patients were compared.Then univariate and multivariate analyses were performed for tumor diameter,ADC value of solid component,bone destruction,peritumoral edema and CSF spaces enhancement of tumor parenchyma margin on CE-T1WI/CE-T2-FLAIR between the benign and malignant groups.Finally,the sensitivity and specificity of CE-T1 WI and CE-T2-FLAIR in predicting malignant meningioma were calculated.2.In this study,19 patients whose tumor location was not close to the brain surface and 18 cases whose tumor diameter less than 2 centimeters were excluded from the 125 patients with meningioma finally enrolled in Study 1.Finally,a total of88 patients were enrolled for the second part of the study,among which 64 were benign and 24 were malignant.In addition,67 patients with suspected high-grade glioma and 63 patients with suspected metastatic tumor were enrolled during the same period of time,all of which suffered heard MRI routine scan and enhanced scan.3glioma patients and 10 metastatic tumor patients with poor image quality were excluded,finally,64 patients and 30 patients with postoperative pathological confirmation of high-grade glioma and metastatic tumor were enrolled.33 patients suspected of metastatic tumor with a history of primary tumor and focal shrinkage after follow-up clinical treatment were also enrolled in the study.Finally,a total of 64 patients with high-grade glioma and 63 patients with metastatic tumor were enrolled in the study.All imaging features were assessed by visual score.The grade of tumor parenchyma enhancement,thin layer enhancement of tumor parenchyma margin were compared in CE-T1WI/CE-T2-FLAIR between meningioma group,glioma group and metastatic tumor group.The statistically significant features were compared in pairs between groups.Results:1.There were statistical differences of multiple imaging features(tumor diameter,bone destruction,peritumoral edema,CSF spaces enhancement of tumor parenchyma margin on CE-T1WI/CE-T2-FLAIR)between benign group and malignant group by univariate analysis((49)<0.05).Compared with the benign group,larger diameter,bone destruction,peritumoral edema and CSF spaces enhancement of tumor parenchyma margin on CE-T1WI/CE-T2-FLAIR were more common in the malignant group.Further multivariate analysis of the single factor with statistical difference showed that the three factors of bone destruction,CSF spaces enhancement of tumor parenchyma margin on CE-T1 WI and CE-T2-FLAIR were statistically significant between the two groups((49)<0.05),and they were more common in the malignant group than in the benign meningioma group.The prediction specificity of CSF spaces enhancement of tumor parenchyma margin on CE-T1 WI for malignant meningioma was higher(98.00%)than that of CE-T2-FLAIR(45.00%).The prediction sensitivity of CSF spaces enhancement of tumor parenchyma margin on CE-T2-FLAIR for malignant meningioma was higher(96.00%)than that of CE-T1WI(28.00%).2.Firstly,there were significant differences among the three groups in the grade of tumor parenchyma enhancement on CE-T2-FLAIR,the thin layer enhancement of tumor parenchyma margin on CE-T1WI/CE-T2-FLAIR((49)<0.05),while there was no statistical difference in CE-T1 WI tumor parenchymal enhancement degree((49)> 0.05).Secondly,the pairwise comparison between the three groups showed statistically significant difference in the grade of tumor parenchyma enhancement on CE-T2-FLAIR for meningioma(5)glioma and meningioma(5)metastases((49)<0.0167).Compared with the three groups,the grade of tumor parenchyma enhancement for glioma and metastatic tumor was more obvious than that of meningioma,while there was no statistical difference in the enhancement degree of metastases(5)glioma((49)>0.0167).Thirdly,the pairwise comparison between the three groups showed statistically significant difference in the thin layer enhancement of tumor parenchyma margin on CE-T1 WI for meningioma(5)glioma((49)< 0.0167).Compared with the three groups,the thin layer enhancement of tumor parenchyma margin on CE-T1 WI for meningioma was more common than that of glioma,while there was no statistical difference in the enhancement of meningioma(5)metastases and glioma(5)metastases((49)> 0.0167).Finally,the pairwise comparison between the three groups showed statistically significant difference in the thin layer enhancement of tumor parenchyma margin on CE-T2-FLAIR for meningioma(5)glioma and glioma(5)metastases((49)<0.0167).Compared with the three groups,the thin layer enhancement of tumor parenchyma margin on CE-T2-FLAIR for meningioma and metastases was more common than that of glioma,while there was no statistical difference in the enhancement of meningioma(5)metastases((49)>0.0167).Conclusion(s):1.CE-T1 WI and CE-T2-FLAIR can reflect the vascular permeability of parenchymal margin of tumors,which is of certain value in the differentiation of benign and malignant meningiomas.Mean tumor diameter,peritumoral edema,and bone destruction are also different in benign and malignant meningiomas.2.The thin layer enhancement of tumor parenchyma margin on CE-T2-FLAIR sequence is valuable in the identification of intracerebral and extracerebral tumors. |
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