title: A magnetic resonance imaging technique to evaluate tumor-brain adhesion in meningioma: brain-surface motion imaging.
abstract: OBJECTIVE
  We examined the effectiveness of a newly developed magnetic resonance imaging (MRI) technique, brain surface motion imaging (BSMI), in the preoperative evaluation of tumor-brain adhesion in meningioma surgery.
  
  
  METHODS
  Cine phase-contrast MRI was used to measure cerebrospinal fluid (CSF) pulsations and heart rates at 2 different time points to create a subtraction image in meningioma patients who underwent BSMI. With no tumor-brain adhesion, a gap was observed in the tumor-brain movements, resulting in an outline of the tumor in BSMI. If adhesion was evident, no outline was observed. Cases were evaluated as exact if the presence or absence of edema in T2-weighted MRI, BSMI findings, and intraoperative findings all matched; as effected when only BSMI findings and intraoperative images matched; and as false when BSMI findings and intraoperative findings did not match.
  
  
  RESULTS
  BSMI judged 27 patients as adhesion (+) and 33 as adhesion (-), whereas surgical findings evaluated 22 as adhesion (+) and 38 as adhesion (-). The sensitivity and specificity were both high, at 95.5% and 84.2%, respectively. Forty-one of 60 patients were evaluated as exact, 12 as effected, and 7 as false. World Health Organization tumor grade assessment of effected subjects included 16.7% in grade 1 and 36.4% in grade 2.
  
  
  CONCLUSIONS
  BSMI was shown to be effective in evaluating adhesion between the meningioma and the brain, allowing safe and effective removal planning to be carried out preoperatively.
authors: Department of Neurosurgery, Nara Medical University, Nara, Japan. Electronic address: syamada@naramed-u.ac.jp.
authors: Shuichi
authors: S
authors: Yamada
authors: Department of Radiology, Nara Medical University, Nara, Japan.
authors: Toshiaki
authors: T
authors: Taoka
authors: Department of Neurosurgery, Nara Medical University, Nara, Japan.
authors: Ichiro
authors: I
authors: Nakagawa
authors: Department of Neurosurgery, Nara Medical University, Nara, Japan.
authors: Fumihiko
authors: F
authors: Nishimura
authors: Department of Neurosurgery, Nara Medical University, Nara, Japan.
authors: Yasushi
authors: Y
authors: Motoyama
authors: Department of Neurosurgery, Nara Medical University, Nara, Japan.
authors: Young S
authors: YS
authors: Park
authors: Department of Neurosurgery, Nara Medical University, Nara, Japan.
authors: Hiroyuki
authors: H
authors: Nakase
authors: Department of Radiology, Nara Medical University, Nara, Japan.
authors: Kimihiko
authors: K
authors: Kichikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology* / Q000601:surgery; D001929:Brain Edema / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods; D000267:Tissue Adhesions
keywords: Adhesion; MRI; Meningioma; Surgery