Prediction of tumor-brain adhesion in intracranial meningiomas by MR imaging and DSA.
OBJECTIVE
The purpose of this study was to evaluate the usefulness of MRI (magnetic resonance imaging) and DSA (digital subtraction angiography) by using preoperative MRI and DSA findings in the examination of meningiomas before excision. In particular, we focused on their usefulness in predicting tumor-brain adhesion during surgery.


METHODS
The subjects were 36 patients with intracranial meningioma who underwent tumor excision at which time neurosurgeons examined the tumor-brain adhesion. Two neurosurgeons evaluated the degree of tumor-brain adhesion from operation records and videotapes recorded during surgery. Two neuroradiologists retrospectively evaluated the preoperative MRI findings including tumor diameter, signal intensity of the tumor parenchyma obtained with T(2)-weighted imaging (T(2)WI), characteristics of the tumor-brain interface, and degree of peritumoral brain edema. The vascular supply was also evaluated from the preoperative DSA findings. The relationship between these MRI and DSA findings and the degree of tumor-brain adhesion during surgery as classified by the neurosurgeons was statistically analyzed.


RESULTS
The degree of peritumoral brain edema and the shapes and characteristics of the tumor-brain interface, including the findings of FLAIR (fluid-attenuated inversion recovery) imaging and vascular supply observed by DSA, were significantly correlated with tumor-brain adhesion. In particular, the shapes and characteristics of the tumor-brain interface as observed by T(1)-weighted imaging (T(1)WI), T(2)WI, and FLAIR, respectively, as well as the vascular supply observed by DSA, were closely correlated with the degree of tumor-brain adhesion encountered during surgery. According to these results, we developed a method of predicting tumor-brain adhesion that considers the shape of the tumor-brain interface revealed by MRI and the vascular supply revealed by DSA.


CONCLUSIONS
We retrospectively examined the findings of MRI and DSA performed before excision of meningioma and clarified the relationship between the findings and tumor-brain adhesion. We speculated that tumor-brain adhesion can be accurately and simply predicted before surgery with a new method that considers the shape of the tumor-brain interface observed by MRI and vascular supply observed by DSA.
Takeguchi
Takashi
T
Department of Radiology, Ehime University School of Medicine, Shitsukawa, Shigenobucho, Onsengun, Ehime 791-0295, Japan. takegu@m.ehime-u.ac.jp
Miki
Hitoshi
H
Shimizu
Teruhiko
T
Kikuchi
Keiichi
K
Mochizuki
Teruhito
T
Ohue
Shiro
S
Ohnishi
Takanori
T
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D002540:Cerebral Cortex / Q000098:blood supply; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008576:Meningeal Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D018709:Statistics, Nonparametric