title: Application of contrast-enhanced T1-weighted MRI-based 3D reconstruction of the dural tail sign in meningioma resection.
abstract: OBJECT The goal of this study was to investigate the significance of contrast-enhanced T1-weighted (T1W) MRI-based 3D reconstruction of dural tail sign (DTS) in meningioma resection. METHODS Between May 2013 and August 2014, 18 cases of convexity and parasagittal meningiomas showing DTS on contrast-enhanced T1W MRI were selected. Contrast-enhanced T1W MRI-based 3D reconstruction of DTS was conducted before surgical treatment. The vertical and anteroposterior diameters of DTS on the contrast-enhanced T1W MR images and 3D reconstruction images were measured and compared. Surgical incisions were designed by referring to the 3D reconstruction and MR images, and then the efficiency of the 2 methods was evaluated with assistance of neuronavigation. RESULTS Three-dimensional reconstruction of DTS can reveal its overall picture. In most cases, the DTS around the tumor is uneven, whereas the DTS around the dural vessels presents longer extensions. There was no significant difference (p > 0.05) between the vertical and anteroposterior diameters of DTS measured on the contrast-enhanced T1W MR and 3D reconstruction images. The 3D images of DTS were more intuitive, and the overall picture of DTS could be revealed in 1 image, which made it easier to design the incision than by using the MR images. Meanwhile, assessment showed that the incisions designed using 3D images were more accurate than those designed using MR images (ridit analysis by SAS, F = 7.95; p = 0.008). Pathological examination showed that 34 dural specimens (except 2 specimens from 1 tumor) displayed tumor invasion. The distance of tumor cell invasion was 1.0-21.6 mm (5.4 ± 4.41 mm [mean ± SD]). Tumor cell invasion was not observed at the dural resection margin in all 36 specimens. CONCLUSIONS Contrast-enhanced T1W MRI-based 3D reconstruction can intuitively and accurately reveal the size and shape of DTS, and thus provides guidance for designing meningioma incisions.
authors.affiliation: Department of Neurosurgery, Xuzhou Medical College, Xuzhou, Jiangsu Province; and.
authors.forename: Binsheng
authors.initials: B
authors.lastname: You
authors.affiliation: Department of Neurosurgery, Linyi People's Hospital, Linyi, Shandong Province, China.
authors.forename: Yanhao
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Neurosurgery, Linyi People's Hospital, Linyi, Shandong Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Linyi People's Hospital, Linyi, Shandong Province, China.
authors.forename: Qimin
authors.initials: Q
authors.lastname: Song
authors.affiliation: Department of Neurosurgery, Linyi People's Hospital, Linyi, Shandong Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Dai
authors.affiliation: Department of Neurosurgery, Linyi People's Hospital, Linyi, Shandong Province, China.
authors.forename: Xueyuan
authors.initials: X
authors.lastname: Heng
authors.affiliation: Department of Neurosurgery, Linyi People's Hospital, Linyi, Shandong Province, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Fei
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003287:Contrast Media; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D038361:Neuronavigation; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: 3-dimensional reconstruction; DTS = dural tail sign; T1W = T1-weighted; dural tail sign; meningioma; neuronavigation; oncology