磁共振成像预测脑膜瘤病理标志物表达的影像学研究进展

Advances in MRI for Predicting Pathological Biomarker Expression in Meningiomas

摘要: 脑膜瘤是中枢神经系统最常见原发性肿瘤，生物学行为异质性显著，Ki-67、孕激素受体(Progesterone receptor, PR)是评估其侵袭性、指导治疗及判断预后的核心分子标志物。传统术后免疫组化评估存在时效性差、取样误差大的局限，无法满足精准医疗闭环需求。近年磁共振成像(Magnetic resonance imaging, MRI)多模态技术为二者术前无创预测提供有效路径：常规MRI实现初步预判，扩散加权成像(Diffusion-weighted imaging, DWI)及表观扩散系数(Apparent diffusion coefficient, ADC)直方图提升微观评估精度，影像组学与深度学习模型整合多序列数据，临床转化潜力良好。当前研究面临模型泛化不足、多中心MRI数据无标准化、影像–分子机制关联不明等挑战。未来需构建大规模多中心影像–基因组学数据库、推动MRI标准化、解析影像–分子机制，以提升模型准确性与可解释性，推动脑膜瘤精准诊疗落地。

Abstract: Meningioma is the most common primary tumor of the central nervous system, with significant heterogeneity in biological behavior. The Ki-67 proliferation index and progesterone receptor (PR) are core molecular markers for evaluating tumor invasiveness, guiding treatment, and determining prognosis. However, the traditional postoperative immunohistochemical assessment has limitations such as poor timeliness and high sampling error, which cannot meet the needs of a precision medicine closed-loop. In recent years, multimodal magnetic resonance imaging (MRI) technology has provided an effective approach for the preoperative non—invasive prediction of Ki-67 and PR expression. Conventional MRI enables preliminary prediction, while diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) histograms improve the accuracy of microcosmic evaluation. Radiomics and deep learning models integrate multi-sequence data, showing good potential for clinical translation. Current studies face challenges including insufficient model generalization, lack of standardization for multi-center MRI data, and unclear correlation between imaging features and molecular mechanisms. In the future, it is necessary to construct large-scale multi-center imaging-genomics databases, promote MRI standardization, and clarify imaging-molecular mechanisms to improve the accuracy and interpretability of predictive models, thereby facilitating the implementation of precision diagnosis and treatment for meningiomas.