title: Predictors of meningioma consistency: A study in 243 consecutive cases.
abstract: BACKGROUND
  Meningioma is a common neoplasm primarily arising in the central nervous system. Its consistency is considered to be one of the critical prognostic factors for determining surgical resectability. The present study endeavored to investigate predictive factors associated with the tumor consistency.
  
  
  METHODS
  Two hundred and forty-three consecutive participants who underwent resective surgery of meningioma were examined. The authors designed an objective grading system for meningioma consistency and utilized it for assessing consistency among all cases. We focused on the relationship between preoperative tumor characteristics on neuroimaging studies and the consistency.
  
  
  RESULTS
  The tumor attributes on T2-weighted image (T2WI) and fluid attenuated inversion recovery (FLAIR) image were significantly correlated with the tumor consistency (p = 0.004 and 0.045, respectively). The hypointense tumors on both MRI sequences tended to be hard, whereas the tumors showing hypersignal intensity were associated with soft consistency. There was no correlation between the consistency and age, gender, duration of neurologic symptoms, tumor location, size, calcification, cystic portion, en plague appearance, tumor-brain contact interface expressed by cerebrospinal fluid (CSF) cleft, perilesional vasogenic edema, bony status, features on T1-weighted image (T1WI) and pattern of contrast enhancement. In multiple logistic regression analysis, the tumor characteristics on T2WI and FLAIR image were independent factors significantly correlated with the tumor consistency (p = 0.005 and 0.041, respectively). The tumor consistency was also correlated with operative radicalness as evaluated by the Simpson criteria.
  
  
  CONCLUSIONS
  Signal intensity on T2WI and FLAIR image can be used for insinuating meningioma consistency. Presurgical prediction of the consistency is highly valuable in operative planning, particularly in arduous cases.
authors: Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Prannok Road, Siriraj, Bangkok Noi, Bangkok, 10700, Thailand. bunpotsi@yahoo.com
authors: Bunpot
authors: B
authors: Sitthinamsuwan
authors: Inthira
authors: I
authors: Khampalikit
authors: Sarun
authors: S
authors: Nunta-aree
authors: Prajak
authors: P
authors: Srirabheebhat
authors: Teerapol
authors: T
authors: Witthiwej
authors: Akkapong
authors: A
authors: Nitising
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D055815:Young Adult