摘要： 目的  探讨颅内透明细胞型脑膜瘤的临床特点及影像学特征。方法  回顾性分析神经外科手术治疗并经病理明确诊断的10 例颅内透明细胞型脑膜瘤患者的临床资料，平均年龄35.43 岁，病程2 个月~ 7 年。肿瘤分别位于脑桥小脑角区（5 例）、顶叶（1 例）、鞍结节（1 例）、颈静脉孔区（1 例）、小脑幕（1 例）和侧脑室（1 例）。首发症状与病变部位相关，主要表现为头痛（4 例）、步态不稳（2 例）、耳鸣或听力减退（2 例）或视力下降和饮水呛咳（各1 例）。结果  CT 平扫病灶主要呈高密度（6 例）、等密度（1 例）和等或高混杂密度（1 例）。T1WI主要呈等信号（4 例）、低或等混杂信号（4 例）和高信号（2 例）；T2WI呈高或等混杂信号（7 例）、低信号（1 例）、等信号（1 例）和高信号（1 例）；增强扫描病灶呈中度强化（2 例）或明显强化（8 例）。病灶周围可伴水肿（7 例）、硬脑膜尾征（5 例）、囊性变（7 例）、钙化（3 例）、骨膜增厚（1 例）或骨质破坏（5 例）。7 例肿瘤病灶经手术全切除、3 例获次全切除；术后随访11 ~ 120 个月，5 例复发，平均复发时间为55.62 个月。结论  颅内透明细胞型脑膜瘤临床少见，好发于青年患者，无明显性别差异，脑桥小脑角区为好发部位。影像学表现为病灶明显强化、肿瘤灶周围组织水肿、囊性变及骨质破坏。患者预后与手术全切除程度密切相关。

关键词: 脑膜瘤； 细胞膜； 体层摄影术, X 线计算机； 磁共振成像

Abstract: Objective To investigate the clinical features and imaging findings of intracranial clear cell meningioma. Methods The clinical data were reviewed, including presentation, imaging and prognosis of 10 patients suffered from intracranial clear cell meningioma for 2 months-7 years and underwent surgical treatment. The patients included five males and five females with the age from nine to sixty-two years old (mean 35.43). The tumors were located at cerebellopontine angle (CPA) zone (n = 5), parietal lobe (n = 1), tuberculum sella (n = 1), jugular foramen (n = 1), tentorium of cerebellum (n = 1) or lateral cerebral ventricle (n = 1). The initial symptoms included headache (n = 4), gait disturbance (n = 2), hearing loss (n = 2), vision loss (n = 1) and bucking (n = 1) which were associated with the mass locations. Results CT (n = 8) and MRI (n = 10) of 10 patients were retrospectively reviewed. CT findings of the lesions presented with hyperdensity (n = 6), isodensity (n = 1), or isodensity with hyperdensity (n = 1). MRI T1WI showed isointensity (n = 4), hypointensity with isointensity (n = 4) or hyperintensity (n = 2), whereas T2WI isointensity with hyperintensity (n = 7), presented hypointensity (n = 1), isointensity (n = 1), or hyperintensity (n = 1). On gadolinium-enhanced T1WI, moderate enhancement was seen in 8 lesions and marked enhancement was seen in 2 lesions. In initial CT scanning peritumoral edema was found in 7 cases, dural tail sign in 5 cases, cysts in 7 cases, calcification in 3 cases, periosteal proliferation in 1 case and bone destruction in 5 cases. Seven patients underwent complete resection and 3 underwent subtotal resection. Follow-up period was 11-120 months. Recurrence occurred in 5 patients. The mean recurrence time was 55.62 months. Conclusion Clear cell meningioma is a rare meningioma and often occurs in young persons without significant difference in sex. The CPA zone is the most affected area. The prognosis is closely related to the extent of resection. Clear cell meningioma tends to present marked enhancement, peritumoral edema, cystic components, and bone involvement in imaging findings．

Key words: Meningioma, Cell membrane, Tomography, X-ray computed, Magnetic resonance imaging