Intracranial Anaplastic Hemangiopericytoma And Malignant Meningioma:The Study Of Imaging,Pathology And The Expression Of Related Factors

Objective:To investigate the imaging characteristics of the different grading of intracranial hemangiopericytoma(HPC)and malignant meningioma(MM),and to analyse comparatively imaging,pathology and the expression of Ki-67,VEGF,P73 factors in different grading intracranial HPC and MM.Methods:The 21 cases of anaplastic HPC,18 cases HPC and 18 cases MM were confirmde by pathology and analysed retrospectively their imaging performance and pathological data,and find the paraffin to stain Ki-67,VEGF and P73;blinded record all cases of MRI performance signs;The different grading intracranial HPC and malignant meningioma’s expression of Ki-67、VEGF and P73 factors were statistically analyzed by SPSS 11.0 software.Results:①、20 cases were lobulated,9 cases growed cross-leaf in 21 anaplastic hemangiopericytoma.On MRI,the lesions showed mixed iso-high-low signal(n=20)or iso-signal(n=1)on plain T1WI,while mixed high-low signal(n=20)or iso-signal(n=l)on plain T2WI.After contrast injection,heterogeneous enhancement was seen in 19 cases.Significant necrosis and cystic were seen in 16 cases."dural tail sign" in 2 cases.10 cases appeared bony destruction.Significant mass effect in all cases.16 cases showed significant peritumoral edema.Postoperative tumor histology revealed that the tumor cell was density,apparent cellular atypia,mitotic common;Reticular fiber staining showed a large number of slit-like vascular in interstitial.②、9 cases were oval,3 cases growed cross-leaf in 18 hemangiopericytoma.On MRI,the lesions showed mixed iso-low signal(n=10)or iso-signal(n=8)on plain T1 WI,while mixed iso-high signal(n=10)or iso-signal(n=8)on plain T2WI.After contrast injection,significantly enhanced uniform was seen in 10 cases.Significant necrosis and cystic were seen in 7 cases."dural tail sign" in 6 cases.2 cases appeared bony destruction.All cases showed no significant peritumoral edema.Pathology showed:some tumor cells were mild atypia,occasional mitotic figures;Reticular fiber staining showed a large number of slit-like vascular in interstitial.③、14 cases were lobulated or irregular in shape in 18 MM,15 cases of heterogeneous signal intensity,moderate heterogeneous enhancement in 14cases,obvious cystic necrosis in 15 cases.significant bleeding in 3 cases,"dural tail sign" in 13cases,the skull destruction in 7 cases,peritumoral edema was 16 cases.The pathology showed a poorly differentiated tumor cells,mitosis rich,cell density,nuclear increases,deep dyeing,significant atypia,mitotic common;④、Immunohistochemistry:In 21 anaplastic hemangiopericytoma,Ki67 positive cells was high,high expression in 15 cases and low expression in 6 cases,the average number of 18.4%;15 patients of VEGF with high expression and the six cases with low expression;16 patients of P73 staining with high expression and the four cases with low expression,one case with negative expression.In 18 HPC,Immunohistochemistry showed:expression of Ki67 was relatively low,high expression in 3 cases,low expression in 14 cases and negative expression in 1 case,an average of 7%of the number of positive cells;5 patients of VEGF with high expression,low expression of 12 cases,1 case of negative expression;6 cases of P73 staining with high expression,low expression of 10 cases,2 case of negative expression.In 18 MM,immunohistochemistry:Ki67 positive cells was high,high expression in 14 cases and low expression in 4 cases the average number of 22.4%;8 patients of VEGF with high expression,10 cases with low expression;12 cases of P73 staining with high expression and low expression of 6 cases.The expression of Ki67、VEGF and P73 among the intracranial anaplastic HPC,the HPC with the MM’s degree were statistically significant。Conclusion:①、Intracranial anaplastic HPC features as:irregular in shape,lobulated,cross-leaf growth,the rich blood supplying,easy bleeding of the tumor,necrosis,cystic degeneration to heterogeneous signal intensity,significant enhancement,the adjacent skullosteolytic and significant peritumoral edema,which are obvious than the HPC.②、Differential diagionose of anaplastic HPC and MM in imaging:there are no significant difference in cystic、necrosis,bone destruction and peritumoral edema,but in tumor blood flow void phenomenon,bleeding signals、enhance degree and the "dural tail sign" are significant difference between the two:anaplastic HPC blood flow void phenomenon,bleeding signal is more common than MM,the enhancement effect was significantly higher than MM,and "dural tail sign" rare.③、The degree of expression of Ki67 factor among the intracranial anaplastic HPC,HPC and MM:MM was highest,no significant difference between anaplastic HPC and MM,That identified MM and anaplastic HPC high degree of malignancy than the HPC.④、The degree of expression of VEGF factor among the intracranial anaplastic HPC,HPC and MM:expression of the highest degree was anaplastic HPC,MM was followed,HPC was lowest.No significant difference between the MM and the anaplastic HPC,indicating that although anaplastic HPC and MM was considerable degree of malignancy,but the MM’s blood supply was richer than anaplastic HPC.⑤、The expression level of P73 factor among the intracranial anaplastic HPC,HPC and MM:anaplastic HPC and MM were high,HPC was low,anaplastic HPC and MM was no obvious differert.The degree of expression of these three factors showed that MM and anaplastic HPC were higher malignant tumor.