[The significance of morphological changes in the brain-tumor border area for the pathogenesis of brain edema in meningiomas: magnetic resonance tomographic and intraoperative studies].
OBJECTIVE
The aim of the study was to verify a possible correlation between macroscopic changes of the brain-tumor interface (BTI) and the development of a peritumoral brain edema in meningiomas.


METHODS
27 meningiomas were investigated in this prospective study using an optimized inversion-recovery (IR) sequence. After i.v. administration of 0.2 mmol Gd-DTPA/kg axial and coronary images were acquired (slice thickness = 2 mm). The distances of signal altered cortex and obliterations of the subarachnoid space (SAS) were measured at the BTI and related to the pial tumor circumference (cortical-index and SAS-index). Intraoperatively the BTI was divided into the following categories: 0: SAS not obliterated, 1: SAS partially obliterated, 2: direct contact between tumor and white matter, 3: tumor infiltration into brain.


RESULTS
Edema-associated meningiomas showed a significantly (p = 0.0001) increased SAS-index (0.47 vs. 0.07) and cortical index (0.45 vs. 0.0) compared to cases without edema. Intraoperatively 95% of meningiomas with brain edema showed SAS-obliterations, compared to 50% of cases without an edema.


CONCLUSIONS
Arachnoid adhesions at the BTI with obliteration of the SAS seem to play an essential role in the induction of brain edema in meningiomas.
Bitzer
M
M
Abteilung Neuroradiologie, Radiologische Klinik, Universität Tübingen.
Klose
U
U
Nägele
T
T
Mundinger
P
P
Freudenstein
D
D
Heiss
E
E
Voigt
K
K
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology* / Q000601:surgery; D001929:Brain Edema / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008579:Meningioma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA