MRI Predictive Factors of Adhesion Between Supratentorial Meningioma and Surrounding Brain. (16th November 2020)

• Record Type: Journal Article
• Authors: Tanaka, Shingo; Tamai, Sho; Kinoshita, Masashi; Nakada, Mitsutoshi
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_885
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Ninety % of meningioma are benign and are classified as WHO grade I. However meningioma frequently adheres to surrounding brain and make tumor detach difficult during surgery. METHODS: We retrospectively reviewed 164 tumor planes of 36 supratentorial meningioma cases with WHO grade I (parasagittal: 12, convexity: 17, falx: 7) underwent surgical treatment between January 2017 and January 2020. The tumor adhesion to the surrounding brain was defined during surgery as the rupture of arachnoid membrane or leaving tumor capsule due to tight adhesion. The location of MRI image was identified with neuronavigation during surgery and verified reference to operation video postoperatively. We assessed following items, tumor diameter, T2 hyper rim, T1 hypo rim, FLAIR hypo rim, enhanced rim of gadolinium (Gd) - T1 image and FLAIR hyper surrounding brain. We performed univariate analysis for each item with and without adhesion, and extracted predictors for tumor adhesion by logistic regression analysis. RESULTS: We confirmed 93 tumor planes without adhesion and 71 tumor planes adhered to surrounding brain. The cutoff value obtained from the ROC curve for tumor adhesion and tumor diameter was 2.4 (cm). In univariate analysis, tumor diameter≧2.4 (cm), no T2 hyper rim, FLAIR hypo rim and FLAIR hyper of surrounding brain were significantly associated with adhesion. In logistic regression analysis, tumor diameter≧2.4 (cm) (odds ratio (OR) 3.7, P = .003), T2 hyper rim (OR 0.17, P = .003), and FLAIR hyper of surrounding brain (OR 7.2, P < .001) were significantly independent predictive factors for tumor adhesion. CONCLUSION: Meningioma adhesion to surrounding brain might be predicted by tumor diameter ≧2.4 (cm), T2 hyper rim, and FLAIR hyper surrounding brain.