Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T.
BACKGROUND
The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings.


METHODS
Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus.


RESULTS
CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues.


CONCLUSIONS
There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment.
Yamamoto
Junkoh
J
Department of Neurosurgery, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyusyu, Japan. yama9218@med.uoeh-u.ac.jp
Kakeda
Shingo
S
Takahashi
Mayu
M
Aoyama
Yuichi
Y
Soejima
Yoshiteru
Y
Saito
Takeshi
T
Akiba
Daisuke
D
Korogi
Yukunori
Y
Nishizawa
Shigeru
S
D000368:Aged; D003287:Contrast Media; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000601:surgery; D008579:Meningioma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies
D003287:Contrast Media