Quantitative analysis of pathological grading and classification of meningiomas based on multi-sequence MRI image features

HAO Jingru; YUAN Cuiping; FANG Xiaokun; CUI Yan'an

doi:10.3969/j.issn.1674-4136.2025.01.004

Abstract：Objective To explore the clinical application value of multisequence MRI for grading diagnosis of low and high-grade meningiomas,and to analyze the common pathological classification imaging features of grade Ⅰ meningiomas.Methods The clinical data and MRI images of 100 patients with meningiomas confirmed by surgical pathology in Jiangsu Provincial Hospital of Traditional Chinese Medicine were retrospectively analyzed.According to the pathology,the patients were divided into 84 cases in the low-grade group and 16 cases in the high-grade group,and the MRI performances and characteristics of the 2 groups were analyzed;and the common pathological classification of grade Ⅰ meningiomas was also analyzed.Results The differences in the incidence of morphologic regularity and bone changes between the two groups were statistically significant(both P＜0.05);the mean ADC value of the low-grade meningioma group was greater than that of the high-grade group,and the difference in the ratio of ADC values greater than 0.8 mm2/s between the two groups was statistically significant,using 0.8 mm2/s as the cutoff.And the differences between the two groups in the ratio of relative minimum signal intensity,the ratio of maximum signal enhancement,the homogeneity of enhancement,and the ratio of the appearance of dural tail sign were not statistically significant(all P＞0.05).Multifactorial Logistic regression suggested that morphological irregularity was an independent risk factor for high-grade meningiomas(P＜0.05),and its AUC for predicting high-grade meningiomas was 0.741.The T2WI signals of fibrous meningioma in the low-grade group were relatively slightly lower;the T2WI signals of the psammomatous meningioma were very low;the relative lowest-signal-intensity ratio and enhancement degree of the T2WI of the angiomatous meningioma were significantly higher than those of other types.Fibrous meningioma,meningothelial meningioma and transitional meningioma had statistically insignificant differences in T2WI relative low-signal intensity and maximum enhancement ratios.Conclusions Multiple sequence MRI features are valuable for the differential diagnosis of high and low grade meningiomas before surgery,which can provide more accurate diagnostic and therapeutic information for clinical practice.